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The (re)-discovery of the spatial dimension in many sciences has been guided for some time under the designation "spatial turn". Immense progress in geographic information sciences (GIS), global positioning systems (GPS), remote sensing and computer-aided cartography, in addition to geostatistical methods such as spatial distribution analysis and trend analysis, multi-level analysis, spatial data-mining and agent-based modelling, has created entirely new opportunities for spatial analysis and the modelling of spatial, health-relevant processes. These methods are increasingly being employed in epidemiology, public health and healthcare research.In the fields of cultural and social sciences, "spatial turn" refers to a paradigm shift that recognizes that geographical space also has a social and cultural meaning. This spatial conception considers space not only as an empty container, but also as a result of social processes. The Euclidean space is extended by socially and culturally shaped spatial perceptions and constructions. The "spatial turn" as a paradigm shift is not limited to the fact that space itself becomes an object of advanced investigation methods. It is instead about approaching objects of research with spatial categories.In light of the "spatial turn", geographical health research is currently facing great opportunities, but also a double challenge: on the one hand, recognizing, mediating and making meaningful use of the new methodological possibilities. On the other hand, and in line with its self-conception as a part of the medical humanities, it is challenged to implement the "spatial turn" in its social and cultural-scientific dimension, to go beyond stereotypical reception and to meet the paradigmatic significance of "spatial turn".

Public health research is application-oriented, its great potential lies in the interlinking of science and practice, as well as its interdisciplinarity and methodological competence. Public health research is focused on the development and evaluation of measures to protect and improve the health of the population. In doing so, it must make its contribution to tackling the new challenges posed by demographic change, digitalization, new forms of communication and medical progress. By pooling the forces, the public health scientists should actively contribute to policy advice and promoting adequate research funding., Competing Interests: Interessenkonflikt: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Medical actions that have been shown to be beneficial in individual studies may be associated with a negative benefit-harm balance at the population level due to oversupply or undersupply. Therefore, structured dialogues among basic researchers, clinicians and public health researchers are needed to generate relevant public health questions in relation to medical actions and to undertake research projects that answer these questions. For this purpose, more structured PhD programs in public health are required. Implementation barriers for evidence-based medical actions in the population need to be identified and tailored interventions to reduce these barriers need to be developed and evaluated., Competing Interests: Interessenkonflikt: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Competing Interests: Disclosure The authors report no conflicts of interest in this work.

The traditional separation of health care into sectors in Germany causes communication problems that hinder continuous, patient-oriented care. This is most evident in the transition from inpatient to outpatient care. That said, there are also breaks in the flow of information, a lack of supply, or even incorrect information flowing within same-sector care. The transition from a division of functions into sectors to a patient-oriented process represents a change in the paradigm of health care that can only be successfully completed with considerable effort. Germany's statutory health insurance (SHI) funds play a key role here, as they are the contracting parties as well as the financiers of integrated care, and are strategically located at the center of the development process.The objective of this article is to explore how Germany's SHI funds view integrated care, what they regard as being the drivers of and barriers to transitioning to such a system, and what recommendations they can provide with regard to the further development of integrated care. For this purpose semi-structured interviews with board members and those responsible for implementing integrated care into the operations of ten SHI funds representing more than half of Germany's SHI-insured population were conducted. According to the interviewees, a better framework for integrated care urgently needs to be developed and rendered more receptive to innovation.Only in this way will the widespread stagnation of the past several years be overcome. The deregulation of § 140a-d SGB V and the establishment of a uniform basis for new forms of care in terms of a new innovation clause are among the central recommendations of this article. The German federal government's innovation fund was met with great hope, but also implied risks. Nonetheless, the new law designed to strengthen health care overall generated high expectations.

Background and Objectives: Introducing fixed fees for inpatient hospital care has raised fears of a negative influence on treatment quality. To address these concerns, an external quality assurance was implemented. The results of the quality indicators should indicate changes in the quality of inpatient care between 2004 and 2008., Methods: On the basis of the evaluation data delivered by the Federal Quality Assurance Agency, quality indicators with similar results of at least 3 subsequent years were included. A trend was identified with linear regression as well as with a constant change in the results. 204 quality indicators of 19 health care sectors of 6 diagnosis groups were included., Results: Half of the quality indicators showed a particularly striking quality improvement in the categories "indication" and "process". The lowest number of quality indicators with a quality improvement occurred in the cardiac surgery. To this diagnosis group also belong 13 of the 18 quality indicators with deterioration. Sixteen of the 18 quality indicators rank among the category "result"., Conclusion: The quality of inpatient care improved substantially from 2004 through 2008, measured against the quality indicators of the external comparable quality assurance. This corresponds to other analyses of a similar time period in Germany of the same or different data sources. Those analyses showed additionally that the subjective perceptions of clinicians and of nursing staff are significantly worse., (© Georg Thieme Verlag KG Stuttgart · New York.)

Principles and conditions for guideline implementation and evaluation were the subject of a workshop organised by the German Association of the Scientific Medical Societies (AWMF) and the German Network for Health Services Research (DNVF). This report reflects contents and discussions and suggests possible future activities. The workshop highlighted the need for conceptual frameworks, theory-driven research and concerted strategies. The reinforcement of strategic partnerships within the health care organisations is an indispensable prerequisite for successful guideline implementation and evaluation.(As supplied by author)., (Copyright © 2013. Published by Elsevier GmbH.)

External quality assurance has three main aims: to make service provision in medicine and nursing comparable, to systematically identify deficits in service quality and to support the introduction of measures for quality improvement. This article reflects on three major developments in mandatory external quality assurance in the German healthcare system that took place during the last five years. These developments include the implementation of cross-sectoral quality assurance, the utilisation of new data sources and a new focus on quality deficits and practicability. The article highlights the challenges that come along with these developments., (Copyright © 2013. Published by Elsevier GmbH.)

Since 1984, psychiatry in Greece has undergone a gradual and complex evolution. One of the aims of the Psychargos programme which began in 2002 is to deinstitutionalise chronic patients and to implement a system of regionalisation across the whole country. Inserting the momentum of users' and families' associations remains a major objective.

Background: The expectations of health services research are growing with its recognition and acceptance as an independent field within health research. What are the issues that health services research should deal with in future to perform the tasks it will be confronted with? Different health-care players like physicians, scientists, sponsors, and third-party payers were invited to give answers to these questions which was the aim of the workshop held in Cologne on the 8th November 2010. The IMVR (Institute for Medical Sociology, Health Services Research, and Rehabilitation Science, University of Cologne) and WINEG (Scientific Institute of TechnikerKrankenkasse for the Benefit and Efficiency in Health Care) jointly hosted the 'Expert Workshop - Future Issues of Health Services Research' in order to get closer to meeting this goal., Methods: Experts met in 4 focus groups to identify the future issues of health services research in the one-day workshop in Cologne in November 2010. The participants discussed their proposed issues in a moderated session and decided on the key future issues of health services research in a double voting procedure., Results: 36 experts accepted the invitation. Of these 6 were experts of the medical profession, 4 of the group of sponsors, 13 scientific experts and 13 experts of the groups of third-party payers. According to their rating, "intersectoral networking", "patients' preferences", and "the evaluation of innovations, processes, and methods" are the 3 key future issues of health services research., Conclusions: The experts developed the key future issues for health services research according to their opinion. They answered the question on the issues, health services research should be occupied with in future, i.e. a broad range of topics. To a certain extent, they returned to former issues and problems for which satisfactory solutions have not yet been found., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: When it was initiated in 2001, England's national patient survey programme was one of the first in the world and has now been widely emulated in other healthcare systems. The aim of the survey programme was to make the National Health Service (NHS) more "patient centred" and more responsive to patient feedback. The national inpatient survey has now been running in England annually since 2002 gathering data from over 600,000 patients. The aim of this study is to investigate how the data have been used and to summarise what has been learned about patients' evaluation of care as a result., Methods: Two independent researchers systematically gathered all research that included analyses of the English national adult inpatient survey data. Journals, databases and relevant websites were searched. Publications prior to 2002 were excluded. Articles were also identified following consultation with experts. All documents were then critically appraised by two co-authors both of whom have a background in statistical analysis., Results: We found that the majority of the studies identified were reports produced by organisations contracted to gather the data or co-ordinate the data collection and used mainly descriptive statistics. A few articles used the survey data for evidence based reporting or linked the survey to other healthcare data. The patient's socio-demographic characteristics appeared to influence their evaluation of their care but characteristics of the workforce and the. At a national level, the results of the survey have been remarkably stable over time. Only in those areas where there have been co-ordinated government-led campaigns, targets and incentives, have improvements been shown. The main findings of the review are that while the survey data have been used for different purposes they seem to have incited little academic interest., Conclusions: The national inpatient survey has been a useful resource for many authors and organisations but the full potential inherent in this large, longitudinal publicly available dataset about patients' experiences has not as yet been fully exploited.This review suggests that the presence of survey results alone is not enough to improve patients' experiences and further research is required to understand whether and how the survey can be best used to improve standards of care in the NHS.

This article addresses the contribution that health care research can make to facilitating appropriate health care provision for older adults. First, the major risks in this age group are described. These include multiple illnesses, the increasing need for nursing care with age, but also the growing numbers of older adults with psychological disorders, primarily dementia. The second section of the article presents a critical assessment of the current health care situation in light of the risks identified. On this basis, the third section specifies the areas of health care research that can contribute to improving the quality of the health care provision for this population. The article is based on a presentation made by the author at the 2010 Berlin Talks on Social Medicine: "The New Old--Health Care Research for a Changed Society."

The central tasks of health services research include the description and analysis of health care under everyday conditions as well as the development and evaluation of new concepts. As a first step, the reality of the health services' situation should be assessed using representative data. For that, registries, claims data of health insurance funds or observational studies are suitable. To investigate specific patterns or decisions, qualitative methods are of importance. To evaluate the effectiveness of health care concepts or structures, pragmatic randomized, controlled trials are considered to provide the best evidence. In this paper we discuss these questions on the basis of treatment for patients with small renal masses. Although recent guidelines recommend nephron-sparing surgery instead of radical nephrectomy for these patients, international studies suggest that there is a significant underuse of nephron-sparing procedures. However, national data describing the situation in Germany are necessary to analyse reasons and to develop new concepts which subsequently have to be tested in randomized trials. Therefore, the aim of health services research is to create a scientific basis for continuous improvements in health care. Urology needs health services research and we should find ways to overcome barriers to improve quality of care.

In Germany, health services research has become an important area of research. Health services research is a multidisciplinary field of scientific investigation that studies central problems of health care to increase knowledge and understanding and provide solutions for those problems. The paper aims to demonstrate the value of health services research for health care practitioners by defining its central tasks, by describing the development of this research field in Germany and by deriving future challenges for health services researchers.

Health insurance funds need the results of health services research more than ever due to the socio-legal and socio-economic conditions currently prevailing. This should be possible by taking transparency and data protection into consideration, by cooperating with outside researchers while ensuring flexible use of routine data and if necessary gathering additional data, and by establishing links to epidemiological and registry data. It should become normative to clear the way for health insurance funds to regularly include this type of research in budget planning and to this end provide access to a suitable source of funds. In conclusion, it can simply be stated that it no longer suffices to effectively make a new clinically tested procedure, product, and service available because health insurance funds and their partners must know more precisely what this all accomplishes in practice.

Assessment of benefits and quality of medical healthcare treatment is becoming more and more important. In order to accurately carry out this assessment and to assure a reliable planning of health care, valid data are needed. Health services research is an interdisciplinary field of research, which provides information on disease and health care and to uncover suboptimal and incorrect services. This information can be used to improve the quality of treatment and to increase efficiency. In order to obtain information on the health care for skin and allergic diseases the German Center for Health Services in Dermatology (CVderm) was founded in 2005. It is actively involved in the coordination and conducation of health care, collaborating with other university groups.

Canada's approach to shared decision making (SDM) is as disparate as its healthcare system; a conglomerate of 14 public plans at various administrative levels. SDM initiatives are taking place in different pockets of the country and are in different stages of development. The most advanced provincial initiative is occurring in Saskatchewan, where in 2010 the provincial government prepare to introduce patient decision aids into certain surgical specialties. With regard to decision support tools for patients, perhaps the most active entity is the Patient Decision Aids Research Group in Ottawa, Ontario. This group maintains a public inventory of decision aids ranked according to International Patient Decision Aid Standards and has developed the generic Ottawa Personal Decision Guide, as well as a toolkit for integrating decision aids in clinical practice. All of these tools are publicly available free of charge. Professional interest in SDM in Canada is not yet widespread, but Canada's principal health research funding agency is sponsoring several important SDM projects. Researchers from institutions across the country are promoting SDM through continuing professional development programs and other interventions in fields as varied as primary care, dietary medicine and workplace rehabilitation. Still, the future of SDM in Canada remains uncertain. Canada's provincially based structure obliges promoters to work with each province separately, and the recent growth of private healthcare risks dissipating efforts to implement SDM., (2011. Published by Elsevier GmbH.)

The main focus of the present paper is to describe 1) the healthcare system specific influences on patient participation in medical decision making and 2) the current state of research and implementation of shared decision making (SDM) after ten years of substantial advances in health policy and research in this field. WHAT ABOUT POLICY REGARDING SDM? The "Medical Patients Rights Act" is to standardise all the rights and responsibilities within the scope of medical treatment. This also comprises the right to informed decisions, comprehensive and comprehensible information for patients, and decisions based on the partnership of clinicians and patients. WHAT ABOUT TOOLS - DECISION SUPPORT FOR PATIENTS? SDM training programmes for healthcare professionals have been developed and partly implemented. Several decision support interventions - primarily with support from health insurance funds - have been developed and evaluated. WHAT ABOUT PROFESSIONAL INTEREST AND IMPLEMENTATION? Against the background of the German health policy's endorsement of patient participation, the German government and other public institutions are currently funding different research programmes in which shared decision making is playing a substantial role. The development and implementation of decision support tools for patients and professionals as well as the implementation of trainings for healthcare professionals require stronger efforts. WHAT DOES THE FUTURE LOOK LIKE? With the support of health policy and with the utilisation of scientific evidence, the transfer of shared decision making into practice is considered to be meaningful in the German healthcare system. The translation into routine care will remain an important task for the future., (2011. Published by Elsevier GmbH.)

WHAT ABOUT POLICY REGARDING SDM? Since 1999, there has been a small but growing interest by academics, the government, and society as a whole in strengthening patients' and professionals' involvement in shared decision making (SDM). Two governmental policy documents that indicate support for SDM are (1) Health Reform in 2003 and (2) Sanitary Objectives 2011-2020, which includes a brief section on client participation and SDM. WHAT ABOUT TOOLS - DECISION SUPPORT FOR PATIENTS? Research by Chilean academics has highlighted the patients' desire to participate in health decisions and effective approaches for enhancing health professionals' skills in interprofessional SDM; however, little has been done to support this need and the work is centralised in only one academic institution. Decision support tools and coaching interventions are limited to patients considering decisions about managing type 2 diabetes. WHAT ABOUT PROFESSIONAL INTEREST AND IMPLEMENTATION? Although there is increasing attention to studying patients' participation and involvement on their healthcare, little has been studied in relation to professionals' interest in SDM. As well, there are significant challenges for implementation of a country-wide SDM policy. WHAT DOES THE FUTURE LOOK LIKE? The future looks promising given the new health policies, local Chilean research projects, and international initiatives. Collaboration between health professionals, academics, and government policy makers, with public involvement needs to be strengthened in order to promote concrete strategies to implement SDM in Chile., (2011. Published by Elsevier GmbH.)

In its 2009 report the Federal Advisory Council on the Assessment of Developments in the Health Care System developed a model of Primary Care Practices for future general practice-based primary care. This article presents the theoretical background of the model. Primary care practices are seen as developed organisations requiring changes at all system levels (interaction, organisation, and health system) to ensure sustainability of primary care functions in the future. Developments of the elements comprising the health care system may be compared to the developments and proposals observed in other countries. In Germany, however, the pace of these developments is relatively slow., (Copyright © 2011. Published by Elsevier GmbH.)

The growing absolute number of the elderly causes an increase in the number of patients suffering from not only chronic diseases and multimorbidity, but also higher usage of the health care system. In the German Federal State of Mecklenburg-Western Pomerania (MW), the effects of demographic change will be more pronounced than in other regions. The objective of this article is to show the consequences of the changing population structure for the health care system. Using examples from MW, innovative models to secure high quality health care at the population level are presented. Examples include the establishment of subsidiary practices, multidisciplinary ambulatory health care centers, delegation models, ambulatory health care managers, telemedicine, and intensified and improved interdisciplinary networking. In the context of the demographic change, assisted care, adequate symptom control, maintaining personnel competence, preservation of an independent lifestyle with a high quality of life, and stimulation of social participation become priority objectives of medical care. Besides the effectiveness and the quality of results with regard to these objectives, innovative health care models should be economically evaluated at the population level under real life practice conditions.

Demographic change and its impact on the German healthcare system is a subject of great debate. The purpose of this paper is to make projections on disease rates based on the 11th coordinated demographic prediction and population-based data which take into consideration demographic developments. The German population will decrease by approximately 16% until 2050, while at the same time the number of persons aged over 65 years will increase by 38% and the number of individuals aged over 80 years will increase by 156%. Baby boomers cause a vertical wave in the population pyramid. The population pyramid itself will lead to an overproportional increase in the number of elderly persons. Assuming that disease probability stays the same, the incidence of diseases due to advanced age will rise dramatically. Especially diseases, such as community-acquired pneumonia, age-related macula degeneration, dementia, fracture of the femur neck, and myocardial infarction, will by then occur more often. By 2050, some of the most frequent diseases will be hypertension and arthrosis. Thus, the continuous cutting of resources seems rather short minded. It is highly recommended to reconsider the long-run effects before setting a health policy course. A proper social discourse about primary care and prioritization appears to be urgently needed.

Inequalities in health care are often discussed in an undifferentiated way in Germany. Against this background, this article presents an analysis scheme for a classification of relevant studies and an identification of research needs. To this aim, areas of health care are differentiated (ambulant and inpatient care, prevention and health promotion) and a difference is made between access, utilization and quality of care. According to this scheme, research regarding inequalities in health care can be conducted in nine fields. For each field, exemplary results of a recent study from Germany are summarized. It becomes apparent that there is a substantial lack of systematic research in inequalities in health care in Germany.

Background: In 1974 the Medical Aid Program for Chronic Pediatric Diseases of Specified Categories (MAPChD) was established in Japan, and the national registration of MAPChD beneficiaries was initiated in 1998. In 2005, MAPChD became legal. The purpose of the present study was to analyze the newest registration data and discuss the future prospects of MAPChD. The differences in MAPChD content before and after legislation were compared., Methods: The subjects were MAPChD-registered patients whose guardians had signed a consent document for the children to join a MAPChD research program during the fiscal years 2002-2003. The nationwide electronic registration data were gathered and analyzed, and the official documents about MAPChD were reviewed and summarized., Results: Given that the overall population was aged 0-19 years, there were four MAPChD beneficiaries for every 1000 children in Japan. Moreover, the prolonged survival of MAPChD patients was accompanied by an increasing prevalence of complications. The percentages of MAPChD beneficiaries who did not sign a consent document for research were 3.1% and 6.3% in 2002 and 2003, respectively. Following the legislation, both inpatients and outpatients younger than 20 years with any of 514 chronic diseases became eligible, and MAPChD began providing welfare services to these patients., Conclusions: The establishment of a MAPChD database is necessary for further research. It is expected that, in future, more beneficiaries of MAPChD will join the research program. One of the major challenges faced by long-term survivors of childhood MAPChD diseases is making the transition from a specialized pediatric care facility to an adult health care system.

By building up an integrated framework of political initiatives, distribution of specific knowledge, consulting, networking and tools for gender mainstreaming, the state of North Rhine Westphalia was successful in integrating a gender perspective into the health system from 2001 to 2006. The process developed in concentric circles--starting with women's rights initiatives, then reaching health politics--and has meanwhile reached health services. Important determinants for success were (1) statewide campaigns and offers of gender-specific consulting that distributed the topic to the city level and health services, (2) the linking of gender mainstreaming and the debate about quality in health services, (3) referring to specific health requirements or health problems of women or men and (4) a precise definition of 'sex' and 'gender'. A difficulty in implementing gender-sensitive approaches in the health system is seen in connecting specific medical or public health knowledge with the more general gender competence. To further promote gender sensibility, gender knowledge and gender-specific approaches to health and illness, an integration of gender mainstreaming tools into strategies and tools of project or quality management is proposed.

Background: User involvement in mental health services research is discussed in Great Britain, and a number of user-led research initiatives can be found. In Germany, less attention is paid to the concept while virtually no initiatives can be found., Method: The concept of user involvement is introduced by reviewing the relevant literature. After discussion of theoretical and methodological implications, practicability of the concept for mental health services research is illustrated by some examples from Great Britain., Results/discussion: User involvement in mental health services may promote the provision of user focused services. User involvement aims at the empowerment of mental health service users and can also improve the quality of mental health services research. Frequently, user-led/collaborative studies are focused on mental health service assessment. Some problematic aspects (e. g. representativeness, knowledge/skills of users) are discussed. Although more research is needed to document the additional benefit of user involvement in mental health services research it is conceivable that the concept will gain in importance.

A second Dutch National Survey of General Practice was carried out in 2001 with the aim of providing actual information about the role of general practice in the Dutch health-care system for researchers and policy makers. Data were collected on different levels (patients, general practitioners, practices) and included morbidity (self-report and presented to general practitioners), diagnostic and therapeutic interventions, doctor-patient communication, and background characteristics. Compared to 1987 (the first National Survey), Dutch general practitioners had organized their work more efficiently. Patients were less satisfied (78% satisfied) about the organizational aspects of general practice care than about the care actually provided (90% satisfied). Dutch general practitioners provide high-quality care: on average, their performance was in 74% of cases in accordance with national guidelines. Communication in general practice had become less social and more medically oriented compared to 1987. General practice still acts in a gatekeeper role; this is illustrated by 96% of contacts handled solely by the general practitioner.

The appropriateness of the German Official Severe Disability Statistics for determining the amount of care needed by disabled persons is a controversial issue and therefore in the focus of this article. The criteria for determining the care required by disabled persons are pointed out. Data on prevalence and incidence exemplify that Official Severe Disability Statistics is only partially appropriate for assessing future care requirements. The problems become particularly obvious in topics of data collection, data processing and data storage. The deletion of the statistical data at regular intervals of five years makes long term prognosis almost impossible. While the problems concerning data processing and data storage could be solved by few modifications, the improvement of data collection could only be achieved by including and applying the International Classification of Functioning (ICF) of the WHO.

In Germany's outpatient care, quality circles are strongly encouraged as a tool for peer review in order to implement quality assurance and management in daily practice. This paper presents an overview of the status of implementing quality circles in outpatient care. The main features of successful quality circles are described in terms of conditions, structures, and methodological approach. The objectives of quality circles are outlined, and it is discussed to which extent the quality circle concept is established. Recommendations for further developments of quality circles are drawn from this analysis.

In Germany, health services research geriatric problems is not of major scientific and political importance. Focusing on geriatrics, it is essential to produce good data concerning efficacy, effectiveness and costs of the interventions. Otherwise, the discussion about the allocation of resources in the German health care system will take place without good arguments for special geriatric interventions. Prerequisite for this goal is the definition of adequate endpoints targeting functional deficits and the operationalization of multi- and comorbidity. Another problem is research focused on the "black box" of specific geriatric interventions. A special German situation is the distinction between acute and rehabilitative geriatric settings where very similar patients are treated. For this reason, it is essential for the geriatrician in the German context to focus more on health services research to demonstrate with scientific evidence their important contribution for the care of the elderly.

Surgical quality control may be developed in applied research. Using methods of clinical epidemiology, the efficacy of therapeutic and diagnostic procedures may be tested in wide fields of patient care. Thereby deficits may be unvealed very rapidly. Applied research pointing towards patient care has to be interdisciplinary and multicentric. A specific role has to be taken by the local boards of medicine.

In examining the importance of data systems, conceptual models, and serendipity in understanding health services, the case is made for a vigorous and responsive data infrastructure and more emphasis on conceptual development. Particularly important is the development of data systems that can keep pace with changes in health care organization and patterns of care. Three examples--from managed care, deinstitutionalization, and physician remuneration--demonstrate the need to empirically examine seemingly obvious assumptions about health patterns and trends, and the lessons to be learned when assumptions are proved incorrect. Major future challenges include incorporating patient preferences into outcomes research, meaningful communication about treatment options and health plan choices, and understanding how organizational culture and norms affect decision processes.

Usually, only recent developments concerning application for, treatments and costs of inpatient rehabilitation are in focus and reported regularly to all those involved. This contribution, however, analyses the long-term development of data in the context of rehabilitation under the German statutory pension insurance scheme since 1968, seeking to gain insights relative to the present and future situation in the field of rehabilitation.