Effects of case management on reintegration into work after vocationally oriented medical rehabilitation

Claims for smooth transition from medical to vocational rehabilitation became a central topic in the last years - especially after a new social law (german: Sozialgesetzbuch) was inured in 2001. In order to enhance functional health as well as the ability to work, patients should be prepared and supported to return to work on an early stage of the rehabilitation process.

At the Klinik Niederrhein patient with an especially difficult vocational situation (e.g. unemployment, unstable work situation, doubtful to be able to return to work) are assigned to a vocationally orientated medical rehabilitation (german: medizinisch-beruflich orientierte Rehabilitation, MBOR). Due to the fact that transfer from clinic setting into everyday life is often difficult, the current research project implements an additional case management after the rehabilitation. This case management process attempts to perpetuate and stabilize the progress made during rehabilitation and to support the former patients on their way back into work. For the study patients with metabolic or gastro-intestinal diseases with a difficult vocational situation are recruited at the beginning of their rehabilitation.

In order to assess the effectiveness of the case management on reintegration, the RWTH Aachen conducts an external formative and summative evaluation. Additionally, psychological variables like motivation and self-efficacy are assessed in order to substantiate the results. The study design involves three groups of patients with different interventions who are asked four times to fill out a questionnaire (beginning and end of rehabilitation as well as 6 and 12 months after rehabilitation). In this way, predefined target and control variables are assessed. Patients with a low level of motivation to reintegrate into work receive work-related lectures (MBOR level 1). Patients with a high level of motivation take part in work related group sessions additionally to the lectures (MBOR level 2). Furthermore, level 2 participants are randomly assigned to one of two groups. One group receives the case management after rehabilitation (MBOR-Plus); the other group serves as a control group without further intervention.

The research project was launched in July 2016 and is funded by the research network for rehabilitation of the Deutsche Rentenversicherung Rheinland (refonet).