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The Post-corporatist Rehabilitation System in Germany: High Potential, Critical Moments

  • Ingo BodeEmail author
Chapter

Abstract

This chapter explores the institutional and organizational context of Germany’s rehabilitation system, emphasizing its paradoxes and recent dynamics. Providing a general characterization of that system and its subsectors, it argues that rehabilitation in Germany exhibits a rather holistic orientation, taking shape in a specialized professional field outside acute healthcare and community care. Conversely, the infrastructure of both the funding and supply side appears disintegrated in various respects. The chapter also illustrates how recent shifts in the governance of rehabilitation tend to exacerbate this complexity and extant fragmentation, irrespective of parallel efforts to endorse the aforementioned holistic orientation. Given the subtle influence of the New Public Management (NPM) mantra, individual users are becoming increasingly responsible for ensuring an integrated service trajectory, which proves a high burden for people needing more sophisticated, case-specific support.

References

  1. B.A.R. (Bundesarbeitsgemeinschaft Rehabilitation). (2018). Trägerübergreifende Ausgaben für Rehabilitation und Teilhabe [Expenditure for rehabilitation and participation across providers] Rehab-Info 1-2018. www.bar-frankfurt.de/publikationen/reha-info/reha-info-012018/traegeruebergreifende-ausgaben-fuer-rehabilitation-und-teilhabe/. Accessed 15 Dec 2018.
  2. Bethge, M. (2017). Rehabilitation und Teilhabe am Arbeitsleben [Rehabilitation and participation in working life]. Bundesgesundheitsblatt, 60, 427–435.CrossRefGoogle Scholar
  3. Bode, I. (2008). Aging and the welfare state in Germany. In C. Aspalter & A. Walker (Eds.), Securing the future for old age in Europe (pp. 223–250). Taipei: Casa Verde.Google Scholar
  4. Bode, I. (2010). Towards disorganised governance in public service provision? The case of German sickness funds. International Journal of Public Administration, 33(2), 61–72.CrossRefGoogle Scholar
  5. Bode, I. (2011). Creeping marketization and post-corporatist governance: The transformation of state–nonprofit relations in continental Europe. In S. D. Phillips & S. Rathgeb Smith (Eds.), Governance and regulation in the third sector (pp. 115–141). London: Routledge.Google Scholar
  6. Bode, I. (2019a). Publicness in times of market accountability: Lessons from a changing hospital industry in Germany. Public Policy and Administration, 34(1), 3–21.CrossRefGoogle Scholar
  7. Bode, I. (2019b). Let’s count and manage – And forget the rest. Understanding numeric rationalization in human service provision. Historical Social Research, 43(2), 131–154.Google Scholar
  8. Bode, I., Champetier, B., & Chartrand, S. (2013). Embedded marketization as transnational path departure. Assessing recent change in home care systems comparatively. Comparative Sociology, 12(6), 821–850.CrossRefGoogle Scholar
  9. Bothfeld, S., & Rosenthal, P. (2018). The end of social security as we know it – The Erosion of status protection in German labour market policy. Journal of Social Policy, 47(2), 275–294.CrossRefGoogle Scholar
  10. Buschmann-Steinhage, R. (2017). Trends in der medizinischen rehabilitation. Angebotsstruktur und Zielgruppen [Trends in medical rehabilitation. The supply-side structure and target groups]. Bundesgesundheitsblatt, 60(4), 368–377.CrossRefGoogle Scholar
  11. Deutsche Rentenversicherung Bund. (2018). Reha-Bericht 2018. Berlin.Google Scholar
  12. Farin, E., Follert, P., Gerdes, N., Jaeckel, W. H., & Thalau, J. (2004). Quality assessment in rehabilitation centers: The indicator system ‘quality profile’. Disability and Rehabilitation, 26(18), 1096–1104.CrossRefGoogle Scholar
  13. Kersten, P., Lundgren-Nilsson, A., & Batcho, C. S. (2015). Rethinking measurement in rehabilitation. In K. McPherson, B. Gibson, & A. Leplège (Eds.), Rethinking rehabilitation. Theory and practice (pp. 209–226). Boca Raton: CRC Press.Google Scholar
  14. Kjaer, P. F. (2016). From corporatism to governance: Dimensions of a theory of intermediary institutions. In E. Hartmann (Ed.), The evolution of intermediary institutions in Europe. From corporatism to governance (pp. 11–28). Berlin: Springer.Google Scholar
  15. Klenk, T., & Pavolini, E. (Eds.). (2015). Restructuring welfare governance. Marketization, managerialism and welfare state professionalism. Cheltenham: Edward Elgar.Google Scholar
  16. Klie, T. (2017). Kooperation und Integration: die Herausforderung Rehabilitation vor Pflege [Cooperation and integration: The challenge of prioritizing rehabilitation over elderly care]. In K. Brandhorst (Ed.), Kooperation und Integration – das unvollendete Projekt des Gesundheitssystems [Cooperation and integration: The unfinished mission of the healthcare system] (pp. 263–283). Wiesbaden: Springer VS.CrossRefGoogle Scholar
  17. Meinert, R. G., & Yuen, F. (Eds.). (2014). Introduction. In Controversies and disputes in disability and rehabilitation (pp. 1–4). New York/London: Routledge.Google Scholar
  18. Mittag, O., Kotkas, T., Reese, C., Kampling, H., Groskreutz, H., de Boer, H., & Welti, F. (2018). Intervention policies and social security in case of reduced working capacity in the Netherlands, Finland and Germany. A comparative analysis. International Journal of Public Health, 63(9), 1081–1088.CrossRefGoogle Scholar
  19. Mladenov, T., Owens, J., & Cribb, A. (2015). Personalisation in disability services and healthcare: A critical comparative analysis. Critical Social Policy, 35(3), 307–326.CrossRefGoogle Scholar
  20. Murphy, J. W. (2014). Service delivery, community development, and disability. In R. Meinert & F. Yuen (Eds.), Controversies and disputes in disability and rehabilitation (pp. 155–164). New York/London: Routledge.Google Scholar
  21. Ramm, D. (2017). Die Rehabilitation und das Schwerbeschädigtenrecht der DDR im Übergang zur Bundesrepublik Deutschland. Strukturen und Akteure [Rehabilitation and disability law in the GDR during the transition to the Federal Republic of Germany. Structure and actors]. Kassel: Kassel University Press.Google Scholar
  22. Safilios-Rothschild, C. (1970). The sociology and social psychology of disability and rehabilitation. New York: Random House.Google Scholar
  23. Seel, H. (2015). Zentrale, trägerübergreifende Anlaufstellen – Ansätze, Hindernisse, Perspektiven [One-stop service units – approaches, barriers, prospects]. In L. Mülheims, K. Hummel, S. Peters-Lange, E. Toepler, & I. Schuhmann (Eds.), Sozialversicherungswissenschaft [The science of social security] (pp. 867–881). Wiesbaden: Springer VS.Google Scholar
  24. Stratil, J. M., Rieger, M. A., & Völter-Mahlknecht, S. (2017). Cooperation between general practitioners, occupational health physicians, and rehabilitation physicians in Germany: What are problems and barriers to cooperation? A qualitative study. International Archive for Occupational and Environmental Health, 90(6), 481–490.CrossRefGoogle Scholar
  25. Strauss, A. L., Schatzman, L., Ehrlich, D., Bucher, R., & Sabshin, M. (1963). The hospital and its negotiated order. In E. Freidson (Ed.), The hospital in modern society (pp. 147–169). London: Collier-Macmillan.Google Scholar
  26. SVR (Sachverständigenrat zur Begutachtung der Entwicklung im Gesundheitswesen) [Expert Group for Reviewing the Development of the Healthcare System]. (2014). Bedarfsgerechte Versorgung – Perspektiven für ländliche Regionen und ausgewählte Leistungsbereiche [Need-based services – Perspectives for rural regions and selected service areas]. Bern: Verlag Hans Huber.Google Scholar
  27. Treib, O., Bähr, H., & Falkner, G. (2007). Modes of governance: Towards a conceptual clarification. European Journal of Public Policy, 14(1), 1–20.CrossRefGoogle Scholar
  28. Verschraegen, G. (2015). The evolution of welfare state governance. In K. Van Assche, R. Beunen, & M. Duineveld (Eds.), Evolutionary governance theory (pp. 57–71). Berlin: Springer.Google Scholar
  29. von Eiff, W., Schüring, S., & Niehues, C. (2011). REDIA: Auswirkungen der DRG-Einführung auf die medizinische Rehabilitation. Ergebnisse einer prospektiven und medizin-ökonomischen Langzeitstudie 2003 bis 2011 [The impact of the introduction of DRGs on medical rehabilitation. Findings of a prospective and medical-economic long-term study]. Münster: LIT.Google Scholar
  30. Weber, S. (2014). Leistungsverträge in der Behindertenhilfe. Wohlfahrtspflege zwischen Tradition und Ökonomisierungserwartung [Performance contracts in support for disabled people. Welfare provision between tradition and expectations to make it more economic]. Marburg: Tectum.Google Scholar
  31. Welti, F. (2019). Work disability policy in Germany: Experiences of collective and individual participation and cooperation. In E. MacEachen (Ed.), The science and politics of work disability prevention (pp. 171–188). New York/London: Routledge.Google Scholar
  32. Xyländer, M., & Meyer, T. (2018). Qualitätsentwicklung in Gesundheitsorganisationen am Beispiel der medizinischen Rehabilitation mit einem besonderen Blick auf Ergebnisqualität und die Rolle der Professionen [Quality management in healthcare organizations. The example of medical rehabilitation, focusing quality performance and the role of professions]. In P. Hensen, & M. Stamer (Eds.), Professionsbezogene Qualitätsentwicklung im interdisziplinären Gesundheitswesen. Gestaltungsansätze, Handlungsfelder und Querschnittsbereiche [Professional quality management in an interdisciplinary healthcare system. Management models, action fields, and cross-sectional areas] (pp. 119–140). Wiesbaden: Springer VS.Google Scholar

Copyright information

© The Author(s) 2019

Authors and Affiliations

  1. 1.Institute of Social Work and Social WelfareKasselGermany

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