Sandstrom R, Hoppe K M, Smutko N C
Department of Physical Therapy, Creighton University, Omaha, NE, USA.
Health Care Superv. 1996 Dec;15(2):44-54.
The development of new models of understanding the disabling process, the changing system of financing health care in the United States, and the increasing incidence of disability is challenging rehabilitation to define new models of care delivery. Current models of comprehensive medical rehabilitation include multidisciplinary therapy in inpatient, outpatient, home and community settings. Managed care and the development of capitated funding systems for health care financing will challenge rehabilitation to prevent disability in a population. This article proposes a model system for comprehensive rehabilitation in managed care: the Community Integration Rehabilitation Model. This system advocates the development of a continuum of services including a strong community-based rehabilitation system, that is, a shift in emphasis to expanding opportunities for independent and productive community living as well as management of disease and impairment for individuals with disabilities, and the forging of partnerships between institution-based rehabilitation and its community. Comprehensive rehabilitation is redefined as a continuum of disability prevention and treatment across the lifespan of a population.
对致残过程理解的新模式的发展、美国不断变化的医疗保健融资体系以及残疾发生率的上升，都对康复领域提出了挑战，要求其界定新的护理提供模式。当前的综合医学康复模式包括在住院、门诊、家庭和社区环境中的多学科治疗。管理式医疗以及医疗保健融资的按人头付费系统的发展，将促使康复领域在人群中预防残疾。本文提出了一种管理式医疗中的综合康复模式系统：社区融合康复模式。该系统主张发展一系列连续的服务，包括强大的基于社区的康复系统，即重点转向为残疾人扩大独立和有成效的社区生活机会以及疾病和损伤管理，以及在机构康复与其社区之间建立伙伴关系。综合康复被重新定义为在人群的整个生命周期内预防和治疗残疾的连续过程。
