Complex inpatient rehabilitation
The complex inpatient rehabilitation (KSR) is a special form of inpatient treatment under the employer's liability insurance association.
The accident insurance institutions have the statutory mandate ( SGB VII § 34 ) to take all measures to ensure appropriate treatment that begins as early as possible . Depending on the type and severity of the damage to health, you can provide for special treatment methods.
Historical development
The statutory accident insurances developed procedures for the implementation of multimodal, complex therapeutic measures. In the field of inpatient rehabilitation , the professional association inpatient further treatment (BGSW) was introduced in 1991 . In outpatient rehabilitation there since 1991 in the Administrative Professional Association (VBG) for high-performance athletes , the particular indexed therapy (BiTh). This was adopted in 1995 as Extended Outpatient Physiotherapy (EAP) by all professional associations . Both BGSW and EAP focus on the treatment of disorders of entire functional chains if it is evident that the rehabilitation result cannot be achieved sufficiently or only with a delay with conventional standard therapies.
The range of services offered by BGSW is often insufficient for complex injury patterns (e.g. after multiple trauma ) and delayed healing processes. The examination of possible conservative or surgical therapy options requires quick access to various acute medical specialties and extensive diagnostic methods. This combination of acute medicine and rehabilitation resulted in the complex inpatient rehabilitation (KSR) in the accident clinics of the employers' liability insurance association .
Special form of the trade association healing process
At KSR, the focus is on extensive diagnostic and therapeutic services. It is in the hierarchy of the employer's liability insurance association treatment procedures alongside the BGSW procedure and is a special form of the employer's liability insurance association inpatient treatment. The KSR is reserved for the employers' liability insurance association clinics and special wards as a treatment option, as the necessary independence from referring clinics exists here and all necessary diagnostic, therapeutic and, if necessary, surgical treatment options are available.
features
The need for such intensive medical rehabilitation measures can arise when certain characteristics are met. A measure is basically to be classified as KSR if in particular the following characteristics are met:
- Increased diagnostic effort and therapeutic need
- Multiple psychological consultations
- Repeated multiple consultations in various disciplines
- Significantly increased maintenance effort
- Review of indications for surgery or revision
- About the measure of BGSW beyond physiotherapy and occupational therapy measures
- First aid with individually manufactured aids (e.g. prostheses )
Indications
So far (2010) no separate catalog of indications has been developed for the approval of the KSR. Instead, the catalog of injury types has to be used, e.g. B. at
- Multiple injuries to extremities and trunk
- Paraplegia
- Traumatic brain injury
- severe burn injuries
- severe hand injuries
- occurring complications such as osteitis or dystrophy syndrome
- Limb loss (s) for prosthetic treatment
KSR is also indicated if there is a disproportionate nature and severity of the injury and the duration of the healing process or the expected incapacity for work and consequently further increased diagnostic and therapeutic measures are necessary to enable participation in working life again. The KSR stands between acute medicine and rehabilitation and facilitates so-called interface management.
Web links
literature
- T. Krackhardt. Measures after acute treatment from a medical point of view. Trauma occupational disease 2004; 6 (Suppl 1): S153-S157