[Utilization of services at the Berlin Center of Ambulatory Rehabilitation]. / Inanspruchnahme von Leistungen im Berliner Zentrum für ambulante Rehabilitation.

The Center for Ambulatory Rehabilitation (ZaR) in Berlin provides rehabilitative services for orthopedic and neurological patient problems offering a rehabilitation program that is flexible, individually adapted and close to the patient's home. This paper analyzes the development of utilization of the ZaR using patient application, admission and discharge data for a one year period (April 1997 to March 1998). Treatment was started for 1,009 patients (mean age 51.1 years; 55% female). While mean duration of a treatment period was 28.5 days, overall utilization of the ZaR was 49%, being higher for the neurological department than for the orthopedic department (74% and 40%, respectively). The variety of patient problems treated was fairly small: more than two thirds of the cases treated were patients after stroke (ICD 430-438) in the neurological department and patients with back problems (ICD 721-724) in the orthopedic department, respectively. Acute care hospitals still play a minor role in referring patients to the ZaR. Referrals of many office-based physicians suggest that the ZaR will achieve its intention to provide rehabilitative services close to the patient's home.

[Quality assurance in geriatric rehabilitation--approaches and methods]. / Qualitätssicherung in der geriatrischen Rehabilitation--Ansätze und Methoden.

It did not take the provisions of the 5th Book of the Social Code for quality assurance issues to gain significance in the field of geriatric rehabilitation as well. While in the surgical specialties, experience in particular with external quality assurance have already been gathered over several years now, suitable concepts and methods for the new Geriatric Rehabilitation specialty are still in the initial stages of development. Proven methods from the industrial and service sectors, such as auditing, monitoring and quality circles, can in principle be drawn on for devising geriatric rehabilitation quality assurance schemes; these in particular need to take into account the multiple factors influencing the course and outcome of rehabilitation entailed by multimorbidity and multi-drug use; the eminent role of the social environment; therapeutic interventions by a multidisciplinary team; as well as the multi-dimensional nature of rehabilitation outcomes. Moreover, the specific conditions of geriatric rehabilitation require development not only of quality standards unique to this domain but also of quality assurance procedures specific to geriatrics. Along with a number of other methods, standardized geriatric assessment will play a crucial role in this respect.

[Acute pancreatitis with formation of a pancreatic pseudocyst in a six-month-old female infant]. / Akute Pankreatitis mit Pankreaspseudozystenbildung bei einem sechsmonatigen weiblichen Säugling.

Acute pancreatitis and pancreas pseudocysts are rare events in children. We report an infant aged six months with the cardinal symptoms of abdominal pain, vomiting and fever. After the exclusion of an acute abdominal emergency conservative therapy was started. Due to the persistence of the symptoms an explorative laparatomy had to be done on day four of the illness. A postoperative seen fistula of the pancreas was successfully closed by a sandostatin therapy.