[Ambulatory geriatric rehabilitation--concepts, chances and responsibilities of participating physicians]

The third stage of the bill of the health structure (GSG) still focuses on the tremendous increase of costs in hospitals. Hospitals are accused that the care of the older patients involves too much money and staff. Experts complain that geriatric-rehabilitative thinking and acting does hardly influence the daily work on the wards. Competent geriatric rehabilitation should diminish or prevent the need for nursing, should support the patients ability for self-sufficiency, and decrease hospitalization time. Since the expenses for the hospital care of older patients have increased during the last couple of years and show the greatest dynamic of increase together with the supply of aids, health politicians and health economists, physicians, health insurances, and social insurances set more and more medical and economic hope on the geriatric rehabilitation. Especially models of out of hospital programs in connection with panel doctors are discussed to relieve the hospitals and are favoured by legal institutions and health politicians. Despite the documented success of geriatric rehabilitation, it is surprising the only a few areas realize differentiated out of hospital concepts. This article summarizes the most important models of out of hospital geriatric rehabilitation as they are tested in different areas in Germany. Advantages and disadvantages are discussed and the demands of the participating physicians are demonstrated. The goal of this paper is to describe the medical role in these models to win more physicians for this task. The urgently necessary development of a country-wide out of hospital rehabilitation, introduces new important medical fields of activity.