[Partial inpatient cardiologic rehabilitation in an urban satellite center of a rehabilitation clinic: the Munich model].
In April 1996 the Munich Rehabilitation Center was founded by the Social Security Agency as a "satellite center" of the "Klinik Höhenried for Cardiovascular Diseases", which is located 50 km south of Munich near the lake Starnberg and performs in-patient rehabilitation since 1967. The Munich Rehabilitation Center is exclusively designated for outpatient rehabilitation for patients in the Munich area. Monday to Friday from 9 a.m. to 4 p.m. up to 50 patients are treated according to the same standards as in residential centers. About 40% of patients treated are in WHO phase II, e.g. after coronary artery bypass grafting, acute myocardial infarction or a percutaneous transluminal coronary angioplasty. 60% have a chronic stable cardiac disease or risk factors for arteriosclerosis. After almost 3 years of experience we see some specific advantages in outpatient compared to the in-patient setting. Ambulatory treatment seems to be more than the residential center "minus a bed". For example: a "holiday feeling" can be avoided by the location in a city area, so the patients are focusing on medical rehabilitation. Outpatient rehabilitation makes an easy transition from a cardiological center to every day life possible. Some patients would refuse any further treatment far away from home because of personal or occupational reasons. Anxiety can be reduced and self-confidence increased by the outpatient setting. There is a daily feedback about the ability to transfer therapeutic advices home. We learned to appreciate outpatient rehabilitation as a cost-effective supplement to the proven in-patient setting for patients in municipal areas.