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 DRVʼs AHB indication catalogue in September 2024.

Keywords

cochlear implant - rehabilitation - AHB - follow-up treatment - follow-up rehabilitation

Publikationsverlauf

Artikel online veröffentlicht:
05. Mai 2025

• Literatur

• 1 AWMF online. S2k-Leitlinie Cochlea-Implantat Versorgung. AWMF-Register-Nr. 017/071 (10/2020). Zugriff am 13. Februar 2025 unter: https://register.awmf.org/assets/guidelines/017-071l_S2k_Cochlea-Implantat-Versorgung-zentral-auditorische-Implantate_2020-12.pdf
• 2 Rader T, Haerterich M, Ernst BP. et al. Lebensqualität und Schwindel bei bilateraler Cochleaimplantation. Fragebogeninstrumente zur Qualitätssicherung. HNO 2018; 66: 219-228
• 3 DGHNO-KHC. Weißbuch Cochlea-Implantat(CI)-Versorgung (2021). Zugriff am 13. Februar 2025 unter: https://cdn.hno.org/media/2021/ci-weissbuch-20-inkl-anlagen-datenblocke-und-zeitpunkte-datenerhebung-mit-logo-05-05-21.pdf
• 4 Deutsche Rentenversicherung Bund. Medizinische Voraussetzungen der Anschlussrehabilitation (AHB). AHB-Indikationskatalog (09/2024). Zugriff am 13. Februar 2025 unter: https://www.deutsche-rentenversicherung.de/SharedDocs/Downloads/DE/Experten/infos_fuer_aerzte/ahb_indikationskatalog.pdf?__blob=publicationFile&v=1
• 5 Stöver T, Plontke SK, Guntinas-Lichius O. et al. Struktur und Einrichtung des Deutschen Cochlea-Implantat-Registers (DCIR). HNO 2023; 71: 767-778
• 6 Stöver T, Plontke SK, Lai WK. et al. The German cochlear implant registry: one year experience and first results on demographic data. Eur Arch Otorhinolaryngol 2024; 281: 5243-5254
• 7 Stöver T, Plontke SK, Guntinas-Lichius O. et al. Conception and implementation of a certification system for quality control of cochlear implant treatment in Germany. HNO 2023; 71: 73-81
• 8 Günther S, Baumann U, Stöver T. Early Fitting in Cochlear Implantation: Benefits and Limits. Otol Neurotol 2018; 39: e250-e256
• 9 Bruschke S, Baumann U, Stöver T. Long-Term Follow-Up of Early Cochlear Implant Device Activation. Audiol Neurootol 2021; 26: 327-337
• 10 Bruschke S, Baumann U, Stöver T. Residual low-frequency hearing after early device activation in cochlear implantation. Eur Arch Otorhinolaryngol 2023;
• 11 Deutsche Rentenversicherung Bund. Anforderungsprofil für stationäre Einrichtungen zur medizinischen Rehabilitation mit Zulassung zum AHB-Verfahren (01.01.2018). Zugriff am 13. Februar 2025 unter: https://www.deutsche-rentenversicherung.de/SharedDocs/Downloads/DE/Experten/infos_reha_einrichtungen/100_plaetze_zulassung_ahb.pdf?__blob=publicationFile&v=1
• 12 Bruschke S, Zeh R, Baumann U. et al. Frankfurter Konzept einer stationären Cochleaimplantat-Frührehabilitation: Untersuchung zur Durchführbarkeit als Anschlussheilbehandlung. HNO 2024; 72: 412-422
• 13 Dazert S, Thomas JP, Loth A. et al. Cochlear implantation – diagnostics, indications, and auditory rehabilitation results. Dtsch Arztebl Int 2020; 117: 690-700
• 14 Stöver T, Leinung M, Loth A. Welche Qualität macht den Unterschied in der Cochlea-Implantat-Versorgung?. Laryngorhinootologie 2020; 99: S107-S164
• 15 Zeh R, Baumann U. Stationäre Rehabilitationsmaßnahmen bei erwachsenen CI-Trägern. HNO 2015; 63: 557-576
• 16 Baumann U. Cochlea-Implantat-Träger erstreitet Bewilligung einer stationären Hör-Rehabilitation. Das interessante Urteil. Z Audiol 2019; 58: 24-25
• 17 Alsabellha RM, Hagr A, Al-Momani MO. et al. Cochlear implant device activation and programming: 5 days postimplantation. Otol Neurotol 2014; 35: e130-e134
• 18 Wolf-Magele A, Schnabl J, Edlinger S. et al. Postoperative changes in telemetry measurements after cochlear implantation and its impact on early activation. Clin Otolaryngol 2015; 40: 527-534
• 19 Prager JD, Neidich MJ, Perkins JN. et al. Minimal access and standard cochlear implantation: A comparative study. Int J Ped ORL 2012; 76: 1102-1106