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Integration of Digital Therapeutics Into Occupational Rehabilitation in Germany: Multilevel Simulation Study.
Christoph Wallner1, Sonja Verena Schmidt1, Felix Reinkemeier1
1Department for Plastic and Hand Surgery, University Hospital Bergmannsheil Bochum, Bürkle de la Camp-Platz 1, Bochum, 44789, Germany, +49 2343020.
Journal of Medical Internet Research
|May 26, 2026
Summary
Digital health applications (DiGAs) in German occupational rehabilitation can reduce costs by an average of €16.2 million annually and decrease patient waiting times by 26%. This integration offers significant economic benefits and improves access to care.
Area of Science:
- Digital Health
- Health Economics
- Rehabilitation Medicine
Background:
- Rising expenditures for physiotherapy and extended outpatient physiotherapy (EAP) in Germany's statutory accident insurance system (Berufsgenossenschaften) strain rehabilitation capacity and access.
- Digital health applications (DiGAs) offer a novel, reimbursable component for routine rehabilitation but their real-world economic and system-level effects are not well understood.
Purpose of the Study:
- To evaluate the impact of integrating DiGAs into occupational rehabilitation pathways on costs, service capacity, and waiting times.
- To assess these effects within the routine care of 5 German statutory accident insurance funds covering 25.9 million individuals.
Main Methods:
- Analysis of aggregated administrative data (2023-2024) from 5 Berufsgenossenschaften.
- Utilized a multilevel simulation framework combining probabilistic cost-consequence modeling (10,000 Monte Carlo iterations) and an M/M/1 queuing model.
- Incorporated adherence dynamics (15% long-term, 85% short-term users) and validated with discrete event simulation.
Main Results:
- Projected mean annual net savings of €16.2 million (95% CI €5-€29.8 million) with 100% probability of positive financial impact.
- Cost neutrality maintained for DiGA prices up to €617.80 per prescription, significantly above the assumed €450.
- Reduced mean waiting times from 17.3 to 12.8 days (-26%), saving ~120,000 patient days annually for EAP patients.
Conclusions:
- Integrating digital therapeutics into occupational rehabilitation yields economic benefits and enhances system capacity.
- The break-even threshold supports flexible pricing policies for DiGAs.
- DiGAs act as scalable tools to mitigate bottlenecks and improve timely access in capacity-constrained rehabilitation systems.
