From the Department of Physical Medicine & Rehabilitation, Carolinas Rehabilitation, Charlotte, North Carolina; and Department of Supportive Care, Levine Cancer Institute, Charlotte, North Carolina.
Am J Phys Med Rehabil. 2018 Aug;97(8):595-601. doi: 10.1097/PHM.0000000000000943.
Cancer continues to evolve from a terminal diagnosis to a chronic medical condition. With improved survivorship rates, opportunities exist to deliver rehabilitation care throughout the oncology continuum. By definition, inpatient rehabilitation is generally considered postacute care and is provided either in inpatient rehabilitation facilities, in skilled nursing facilities, or in long-term care hospitals. Each institution is subject to specific regulations and legislation that help define appropriateness for admission based on diagnosis, medical necessity, and functional need. However, these criteria may present barriers to access care for the oncology survivor. As the healthcare landscape changes, and reimbursement structures shift from fee-for-service to those that emphasize effectiveness and efficiency in care, inpatient rehabilitation has a unique opportunity to improve value in terms of outcomes and cost. With the implementation of the Improving Medicare Post-Acute Care Transformation Act, standardization of measures throughout postacute care may allow for a more consistent approach to delivery of inpatient rehabilitation care. Further work will be necessary to define the parameters by which oncology survivors should be gauged in this framework.
癌症已从绝症演变为一种慢性疾病。随着生存率的提高，有机会在肿瘤学的整个连续体中提供康复护理。根据定义，住院康复通常被认为是急性后期护理，可在住院康复设施、熟练护理设施或长期护理医院中提供。每个机构都受到特定法规和立法的约束，这些法规和立法有助于根据诊断、医疗必要性和功能需求来确定入院的适宜性。然而，这些标准可能会成为肿瘤幸存者获得护理的障碍。随着医疗保健领域的变化，以及从按服务收费的报销结构向强调护理有效性和效率的结构转变，住院康复有机会在提高治疗效果和降低成本方面提高价值。随着《改善医疗保险急性后期护理转型法案》的实施，整个急性后期护理措施的标准化可能会为提供住院康复护理提供更一致的方法。还需要进一步的工作来确定在这个框架下衡量肿瘤幸存者的参数。
