General practitioners' involvement in inpatient medical rehabilitation in Germany: a scoping review

The German rehabilitation system has some peculiar features, such as the predominance of inpatient medical rehabilitation. Most patients receive inpatient rehabilitation due to chronic illnesses like chronic backpain or psychosomatic diseases. General practitioners play a special role in the German healthcare system as they are often the first point of contact for health issues. The study aims to provide an overview of the involvement of general practitioners in inpatient medical rehabilitation in Germany as well as identifying barriers and facilitators. By doing this, a basis for optimizing general practitioners' involvement can be generated.

A scoping review was conducted to ascertain the current state of scientific knowledge, employing the methodological approach of the Joanna Briggs Institute. The search was carried out between February and March 2024. Eight databases were screened: PubMed, Web of Science Core Collection, PubPsych, EBSCOhost, BeLit, LIVIVO, ProQuest, and German National Library. Publications in German and English in the publication period from 1980 to February 2024 were sought. A thematic analysis was conducted to evaluate the included publications. The research process and generation of findings were recorded utilizing the PRISMA-ScR checklist.

The search resulted in a total of 2231 records, of which 102 were screened on a full text level. Fifty-four publications were included in the review. Following the thematic analysis, fourteen themes were identified and assigned to four topic areas. In the area of access, general practitioners take on a gatekeeper function (addressed by 10 publications) among other things. In follow-up care, there is involvement in prescription (5 publications), like referral to outpatient medical specialists. Barriers to involvement relate, for example, to a lack of knowledge on the part of general practitioners (10 publications) and facilitators include education and training (10 publications).

The results confirm the important role of general practitioners in providing access to inpatient medical rehabilitation in Germany and follow-up care. However, various barriers for general practitioners' involvement were revealed. In order to maintain and optimize the involvement, further scientific research and efforts based on this in practice are necessary, involving relevant stakeholders.