Schmidt-Ohlemann M, Schweizer C
Rehabilitationszentrum Bethesda kreuznacher diakonie, Bad Kreuznach.
Rehabilitation (Stuttg). 2009 Feb;48(1):15-25. doi: 10.1055/s-0028-1105926. Epub 2009 Feb 10.
Domiciliary rehabilitation is an innovative form of outpatient medical rehabilitation. All components of service provision are delivered in the rehabilitant's home by a multidisciplinary team headed by a physician. The key context factors in the rehab process can be taken into account firsthand. The target group of domiciliary rehabilitation consists of multimorbid patients with severe functional limitations and complex assistance needs, whose rehabilitation options would be poor without this outreach service. Here, as suggested by the WHO concept of functional health, the interaction between health condition and environmental factors is kept in view much better than in other forms of rehabilitation. The positive effects and the efficiency of the rehabilitation measures provided can be assessed very well at a high descriptive level. This fact had been a precondition for legal establishment of domiciliary rehabilitation as a regular service. Domiciliary rehabilitation not only complies with key demands in the health and social policy fields, such as priority of outpatient over inpatient treatment or rehabilitation to precede and accompany long term care, it also constitutes an alternative concept challenging the traditional inpatient rehabilitation approach. The patient, hence, no longer is to fit into the institutional framework of outpatient or inpatient rehabilitation, but the team will fit into the specifics of the patient's unique social and material situation.
居家康复是门诊医疗康复的一种创新形式。服务提供的所有环节均由以医生为首的多学科团队在康复者家中进行。康复过程中的关键背景因素能够被直接考虑在内。居家康复的目标群体是患有多种疾病、功能严重受限且有复杂护理需求的患者,如果没有这种外展服务,他们的康复选择会很差。在此,正如世界卫生组织功能健康概念所建议的那样,健康状况与环境因素之间的相互作用比在其他形式的康复中得到了更好的关注。所提供康复措施的积极效果和效率能够在较高的描述层面得到很好的评估。这一事实是居家康复作为常规服务合法设立的一个前提条件。居家康复不仅符合健康和社会政策领域的关键要求,如门诊治疗优先于住院治疗,或康复应先于并伴随长期护理,它还构成了一种挑战传统住院康复方法的替代概念。因此,不再是患者要适应门诊或住院康复的机构框架,而是团队要适应患者独特的社会和物质状况的具体情况。