Challenges in the transition between medical and vocational rehabilitation: a qualitative focus group study with service providers in Germany

Abstract

Purpose

Rehabilitation aims to empower people to cope with their chronic conditions, to ensure societal and vocational participation and to prevent health-related early retirement. In Germany, medical and vocational rehabilitation are unconnected services. Expenditures on health-related early retirement in Germany rise while expenditures on vocational rehabilitation do not. Since the use of rehabilitation services often depends on the transition between services, the present study aims to shed light on barriers and facilitators for the transition between medical and vocational rehabilitation from the perspective of service providers working in different institutions.

Methods

In this sub-study we made use of a qualitative approach and conducted semi-structured focus groups with service providers, namely employees of rehabilitation institutions which we analyzed using Qualitative Content analysis and an inductive-deductive Coding System.

Results

Twenty-four employees of rehabilitation institutions participated in five different focus groups. Especially the pension funds as institutions and medical rehabilitation clinics’ employees of different professions are considered to be relevant professional actors to ensure the continuity of care between medical and vocational rehabilitation. Facilitating and hindering factors include the labour market situation, the Covid-19-pandemic, feedback for employees, an interdisciplinary assessment, different time-related aspects as well as individual factors such as the rehabilitants’ diagnoses.

Conclusion

The findings are largely in line with previous research and point to the difficulty and importance of continuity of care between different rehabilitation services as well as the varying agency and responsibility attributed to different actors. The rehabilitation employees’ view will later be integrated with the perspective of the rehabilitants.