Abstract des Autors

During the last ten years, the public discussion concerning the German health service has been restricting to economic reflections. According to a new law, especially preventive and rehabilitative measures are inquired after cost/benefit relations. In addition to surgical/pharmacological interventions, the ambulant rehabilitation of patients with chronic heart diseases in "heart-groups" has the aim to improve self-responsibility and self-competence for their illness and health situation by professional support. This long-lasting learning process should end in a wholesome behaviour appropriate to the illness. The direct and indirect costs for "heart-group" therapy amount to DM 1.300 to 2.000/pat./yr. Though several studies set up out of the more than 5.000 "heart-groups" in Germany suggest direct (e.g. life quality) and indirect economic (e.g. return to work) benefits, data for a realistic balance are still missing. The results of only few studies in the world show that costs for rehospitalization and loss of productive capacity of patients in able-bodied age can be reduced. A longer life combined with an enhanced life quality can be reached by continuous ambulant rehabilitation over several years. This should be of value for the patients to bear a greater financial share, if necessary. At present it amounts to less than 10% of total costs. Verf.-Referat