Inclusion of a rehabilitation intervention in the catalogue of follow-up rehabilitation using the example of cochlear implant follow-up treatment.

Abstract

As part of a medical treatment or surgical procedure, a rehabilitation programme can be provided. This rehabilitation can also be carried out as so-called follow-up treatment (in German: "Anschlussheilbehandlung", AHB). The German Pension Insurance (Deutsche Rentenverischerung, DRV) has defined several medical interventions that can be conducted by AHB in a catalogue of medical indications. This catalogue is regularly revised and expanded if necessary. This paper describes the process of including cochlear implant (CI) follow-up therapy in the AHB indication catalogue. This process can be considered exemplary for other rehabilitative procedures.The first task was to organize the process of CI treatment in such a way that the formal requirements for AHB were met. The main requirement was that the rehabilitation programme be started within 14 days of discharge from hospital. To ensure this, the initial fitting of the CI processor (as part of the basic therapy) must have taken place beforehand. The concept of early fitting of the CI processor (within 2 to 3 days after surgery) was successfully confirmed in a feasibility study. In a subsequent pilot project, the feasibility and safety of early rehabilitation after CI fitting was also demonstrated. This provided proof in principle of the feasibility of this measure as AHB. After the results of the pilot study were reviewed by the German Medical Service, rehabilitation after CI surgery was included in the DRV's AHB indication catalogue in September 2024.