[Partipants and non-participants with different diagnoses in a post-rehabilitative case management program: a...

Patients covered by the German Pension Insurance Braunschweig-Hannover (DRV BS-H) are offered participation in a case management program after completing medical rehabiliation. The aim of the present study was to compare and identify differences along several parameters between those who took up the offer of CM and those who refused participation in this program.For this cross-sectional study, between 2021 and 2023, members of the DRV BS-H with a recommendation for CM were included in a retrospective survey, that contained items on their disease burden, professional situation and work ability as well as on the evaluation of the medical rehabilitation undergone and the CM. Non-participants were also asked about the reasons for their refusal to particpate. In addition, administrative data of the DRV BS-H were used as a supplement. Group comparison was executed with t-test, Chi²-tests and Mann-Whitney U tests. Predictors were determined using binary logistic regression. Satisfaction with the CM and the reasons for refusal were evaluated descriptively.In many aspects, significant differences were found between participants and non-participants although the effects were mainly small. Non-participants were more likely to suffer from mental illness. They generally considered themselves to be in poorer health, were less likely to be employed and had a poorer prognosis regarding work ability. Participants experienced better outcomes from the retrospective evaluation of medical rehabilitation than non-participants. The evaluation of the CM was consistently positive. The most common reason for rejecting participation in CM was a wish to find a solution themselves. A performance level of less than six hours during the last professional activity increased the probability of participation in CM; however, the regression model had a very low explanatory power.The CM of DRV BS-H is an offer taken up by patients with diverse diagnoses after completing medical rehabilitation, and can be considered as a suitable service for members with complex support needs.