[Need for rehabilitation services: theoretical considerations in "needs assessment"]

Area of Science:

• Rehabilitation Medicine
• Health Services Research
• Medical Sociology

Context:

• Needs assessment is crucial for effective medical rehabilitation provision by statutory pension funds.
• Previous assessments lacked differentiation between rehabilitation neediness, ability, and prognosis.
• North German Association for Rehabilitation Research initiated projects to address these gaps.

Purpose:

• To develop a more objective and differentiated method for assessing medical rehabilitation needs.
• To introduce the "Lübecker algorithm" as a structured framework for needs assessment.
• To distinguish genuine rehabilitation need from concepts like burden of illness, wish, demand, supply, and provision.

Summary:

• The Lübecker algorithm integrates three core components: assessment of health disorders and their consequences (activity limitations, participation restrictions), definition of rehabilitation goals, and selection of appropriate rehabilitative interventions.
• These components form a triangular model where the connections are defined by norms/expectations (disorder-goals), theory (disorder-intervention), and empirical evidence (intervention-goals).
• This framework allows for the objectification of needs assessment, enabling a clear distinction between rehabilitation need and other related concepts.

Impact:

• Provides a more differentiated understanding of rehabilitation need, ability, and prognosis.
• Facilitates objectified needs assessment, improving the precision and fairness of rehabilitation provision.
• Enhances the scientific basis for decision-making in medical rehabilitation planning and resource allocation.