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- Title
Ökonomische Evaluation der Rehabilitation: die Perspektive der Rentenversicherungsträger.
- Authors
Robert, Seitz; Wasem, Jürgen; Christian, Krauth
- Abstract
The pension insurance institutes (Plls) are the most important payer for rehabilitation measures in Germany. In this contribution, the perspective of PIIs is examined and compared to the societal perspective. Besides, measures are developed to translate the PIIs’ perspective for economic evaluation studies. The perspective is examined from both a normative and a positive view (i.e., what is desirable and what is the actual behaviour, respectively). The analyses are based on literature research and findings of an interdisciplinary expert panel including PIIs representatives. The societal perspective shows how to achieve an optimal allocation of resources. The explicit societal instructions are laid down in the Social Code on rehabilitation however. They aim at improving work capacity but also impose a budget for the overall expenditure on rehabilitation. According to the economic theory of bureaucracy, the actual objective of PIIs is especially to maintain or enlarge their discretionary influence on the rehabilitation sector. The proof that rehabilitation measures lead to decreased payments for invalidity pensions and to lower other social expenditure serves as an important method to reach this target. There are possible conflicts both between the societal perspective and the Social Code and within the Social Code instructions. The impact of rehabilitation measures on social expenditure may have persuasive power in the political process and may also be fiscally important. As PIIs are part of the statutory social security system, their evaluation should be based on the societal perspective however — although this perspective requires afar more complex analysis. From a normative point of view, health policy should bring the instructions in the Social Code more into line with the societal perspective.
- Publication
Journal of Public Health (09431853), 2000, Vol 8, Issue 1, p58
- ISSN
0943-1853
- Publication type
Article
- DOI
10.1007/BF02956470