[Is rehabilitation worth it? : Review of economic evaluations of rehabilitation in Germany].

: Because of demographic change, the rehabilitation sector in Germany is going to face increasing demands in the future. Limited budgets make the optimal allocation of resources a top priority. To support decisions about the optimal scope and design of rehabilitation, studies on health economics are of utmost importance. The aim of this article is to provide an overview of the evaluation of rehabilitation with regard to health economics in Germany.Based on a comprehensive literature research, 17 studies on the cost-effectiveness of rehabilitation in Germany were identified. The health economics evaluation focuses on four main topics: patient education (5 studies), the comparison of outpatient and inpatient rehabilitation (7 studies), medico-occupational rehabilitation programs (2 studies) and aftercare programs (3 studies). All four topics show that innovative rehabilitation technologies can be cost-effective. Significant potential savings in program costs of 25-35% are demonstrated in outpatient rehabilitation (with comparable effectiveness with inpatient care). Designated patient education programs often lead to significant savings with indirect costs, by reducing periods of unfitness to work and extending the long-term ability to work. This review article also points out that some relevant areas of rehabilitation, such as the flexibilization of rehabilitation programs or the efficient organization of access to rehabilitation, have not been evaluated sufficiently on the basis of health economics. This article ends with the requirement to carry out more economics-based rehabilitation studies.