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Integrated institution - community rehabilitation in developed countries: a proposal

DISABILITY AND REHABILITATION 2000年第6期22卷 266-274页

作者： Eldar, R Loewenstein Hosp & Rehabil Ctr Fleischman Unit Study Disabil Rehabil Ctr IL-43000 Raanana Israel

Purpose: To propose a system for the provision of comprehensive, coordinated rehabilitation services that would meet all the needs of persons with disability in a timely and cost-effective manner. Methods: Study of the literature pertaining to features of settings available for the delivery of medical rehabilitation in developed countries;presentation of the evolution of a tertiary rehabilitation centre into an institution practicing community-oriented rehabilitation. Review of various issues and implications of integrating institutional-based and community-based rehabilitation. Results: Rehabilitation settings differ in skills and resources and consequently, in the treatment, care and concern they are able to offer. It is essential to find the balance between medical, nursing and social needs of persons with disability and their requirements for skills and resources at a given time, and to provide rehabilitation, support and guidance in the setting most appropriate to these requirements and needs at the lowest cost possible. Conclusion: The integration of the rehabilitation institution of a region with secondary and primary care of the region, into one functional entity for the purposes of providing the needed services, would enable finding the most appropriate setting, and facilitate addressing all needs, as well as increase the availability and accessibility of comprehensive rehabilitation at an affordable cost. This could be a viable way of providing rehabilitation in developed countries of Europe, where the need for it is expected to rise in excess of the population increase.

关键词：社区卫生服务/组织和管理病人医护连续性/组织和管理发达国家残疾人以色列康复/组织和管理人类

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Motor accident and workers' compensation insurance design for high-quality health outcomes and cost containment

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DISABILITY AND REHABILITATION 2000年第1-2期22卷 88-96页

作者： O'Donnell, C Fac Hlth Sci Dept Behav Sci Lidcombe NSW 2141 Australia

This paper studies scheme structure and information concerning rehabilitation outcome for claimants under the NSW Motor Accidents Scheme and the NSW Workers' Compensation Scheme. It argues that to ensure effective rehabilitation there is a need for consistent, national accident schemes which provide services regardless of fault. In general, health outcomes will be improved if dispute resolution and estimation of level of disability occur in a context which avoids adversarialism. On the other hand, negligence could best be punished and compensation provided to victims as a result of prosecution for breach of duty of care under the relevant protective legislation. Other vital elements in injury prevention and rehabilitation are more effective risk management, worker representation and information provision at the workplace level. Comparable performance measures for rehabilitation and other service providers are also necessary for the attainment of quality management and evidence-based medicine.

关键词：事故交通/经济学费用控制卫生保健费用法规新南威尔士卫生保健质量康复/经济学康复/组织和管理危险处理工人补偿金/经济学工人补偿金/组织和管理人类

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Community-based service delivery in rehabilitation: The promise and the paradox

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DISABILITY AND REHABILITATION 2000年第10期22卷 435-445页

作者： Kendall, E Buys, N Larner, J Griffith Univ Ctr Human Serv Nathan Qld 4111 Australia

Purpose: According to many researchers, rehabilitation is being prevented from developing as a distinct profession due to two major problems. First, it has been claimed that rehabilitation is in need of a professional identity and a sense of cohesion if it is to emerge as a discipline. Second, it has been recognized that there is a need for a rehabilitation framework to challenge the restorative approach that continues to dominate rehabilitation, linking it back to the medical model from which it has attempted to escape. The model of community-based rehabilitation (CBR) is offered as a model that can provide the impetus for an attitudinal shift from the restorative tradition and unite rehabilitation workers through a cohesive framework. Method: Unfortunately, the implementation of community based rehabilitation in urban societies has been disappointing. The current paper is a conceptual discussion of community-based rehabilitation that explores some potential causes of this poor implementation. Results: To some extent, the implementation failure of community-based rehabilitation can be attributed to the paradoxes that are inherent in its fundamental constructs-empowerment and community inclusion. These paradoxes occur at a conceptual level, a practical level and a contextual level. Conclusions: Some solutions are offered to enable the paradigm to be implemented more fully. In particular, it is suggested that there is a need to develop useful working definitions of these constructs, favourable attitudes among rehabilitation workers and a focus on community development.

关键词：社区卫生服务/组织和管理卫生保健提供模型理论病人参与康复/组织和管理人类

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上海启动万名癌症患者整体康复行动

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上海医药 2002年第3期23卷 132页

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