[Rehabilitation 2008: when to use outpatient and inpatient rehabilitation?]

Due to illnesses of the cardiovascular system, costs of approximately 35 billion Euros arise in Germany per annum. This corresponds to around 15% of all costs arising in public-health service. Because of a positive influence of high-risk factors, high-risk illnesses, training condition, and lifestyle it is possible to improve the prognosis of the concerned patient within the scope of a training-based cardiac rehabilitation program. Altogether, the final costs of each case will be lowered by a cardiac rehabilitation. A proven advantage of an inpatient rehabilitation program over an outpatient rehabilitation program is not given. As the costs of outpatient measures are less than the costs of inpatient rehabilitation, outpatient measures usually should be preferred. Inpatient rehabilitation should only be carried out with patients who cannot take part in outpatient cardiac rehabilitation programs on account of attendant circumstances (e.g., age, comorbidities, immobility). As there is no adequate overall medical care with outpatient rehabilitation centers in Germany, around 90% of all cardiac rehabilitations usually takes place under inpatient conditions far away from home. In almost every case, however, the realization of close-to-home rehabilitation is to the best advantage. Regardless whether this is realized on an inpatient or outpatient basis, close-to-home rehabilitation also allows the social environment of the patient to be included into the care. Due to being close to home, also long term-based and everyday-attendant rehabilitation types would be possible in future.