Physicians' estimates of rehabilitation requirements after stroke and traumatic brain injury - a questionnaire survey in East Germany

Purpose: The provision of rehabilitation services is organized differently in Germany than most other countries, with large indication-specific in-patient centres. This study is aimed at the rehabilitative knowledge of physicians who initiate and conduct rehabilitation in Germany. Methods: Medical specialists routinely involved in the treatment and rehabilitation of patients with stroke and traumatic brain injury (TBI) from acute hospitals, rehabilitation centres, and the Medical Services of the Workers' Pension Funds of Sachsen-Anhalt and Mecklenburg-Vorpommern were included in a systematic questionnaire survey aiming at the rehabilitation requirements of patients under their care or evaluation. These specialists are crucial for decision-making in rehabilitation ressource allocation. Results: According to these experts, rehabilitation requirements for stroke and TBI patients are dominated by deficits in motor functions and daily-living. They are aware that TBI rehabilitation includes a greater focus on memory functions, problem-solving and attention, and in stroke on language functions. According to the surveyed specialists, the present system of medical rehabilitation in Germany covers the requirements of stroke and TBI patients only partially. Deficits are identified in out-patient and day clinic rehabilitation. Conclusions: Although the knowledge of rehabilitation requirements is adequate in general, its large ranges reflect the necessity for further analysis. The opinions of the surveyed specialists reflect their respective professional setting. Advantages and disadvantages of the German system require further investigation.