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精心打造社区医疗康复的未来:通过叙事性回顾探索非住院康复服务的最佳模式。

Crafting the Future of Community-Based Medical Rehabilitation: Exploring Optimal Models for Non-Inpatient Rehabilitation Services through a Narrative Review.

机构信息

Department of Physical Medicine and Rehabilitation, Soroka University Medical Center, Beer Sheva 84101, Israel.

Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel.

出版信息

Int J Environ Res Public Health. 2024 Oct 8;21(10):1332. doi: 10.3390/ijerph21101332.

Abstract

Community-based medical rehabilitation encompasses diverse programs that cater to patients outside of inpatient settings, such as home rehabilitation, day rehabilitation centers, and ambulatory clinics. While inpatient rehabilitation principles are widely standardized, outpatient programs display significant variability influenced by healthcare models, local environments, economic constraints, and available resources. This narrative review aims to explore and synthesize the various models of non-inpatient rehabilitation services, evaluating their effectiveness, cost-efficiency, and patient satisfaction. The review also seeks to identify optimal practices and strategies to enhance community-based rehabilitation, alleviate the burden on inpatient facilities, and improve patient outcomes through multidisciplinary and patient-centered approaches. Additionally, the study examines the critical role of a professional program coordinator and the importance of effective clinical communication in outpatient rehabilitation. A comprehensive search of peer-reviewed literature was conducted across multiple databases, focusing on studies that examined community-based rehabilitation models. The findings suggest that community-based rehabilitation programs are generally more cost-effective than inpatient programs, with their success being heavily dependent on the intensity and timing of interventions. Multidisciplinary approaches and high-intensity rehabilitation have shown promise in improving patient quality of life, though their effectiveness varies by condition. Despite limited research, the involvement of a Physical and Rehabilitation Medicine (PRM) physician as a program coordinator appears vital for ensuring continuity of care. Moreover, effective clinical communication is essential, impacting all aspects of patient care and interprofessional collaboration, with continuous adaptation required to meet the evolving needs of diverse patient populations.

摘要

社区医疗康复涵盖了各种针对门诊患者的项目,如家庭康复、日间康复中心和流动诊所。虽然住院康复原则广泛标准化,但门诊项目受到医疗模式、当地环境、经济限制和可用资源等因素的显著影响,具有较大的变异性。本综述旨在探讨和综合评估各种非住院康复服务模式的效果、成本效益和患者满意度。本综述还旨在确定最佳实践和策略,以加强社区康复,减轻住院设施的负担,并通过多学科和以患者为中心的方法改善患者的预后。此外,本研究还考察了专业项目协调员的关键作用以及门诊康复中有效临床沟通的重要性。本研究对多个数据库进行了同行评议文献的全面检索,重点研究了社区康复模式的研究。研究结果表明,社区康复计划通常比住院计划更具成本效益,其成功在很大程度上取决于干预的强度和时机。多学科方法和高强度康复已显示出改善患者生活质量的潜力,但具体效果因病情而异。尽管研究有限,但物理医学与康复(PRM)医师作为项目协调员的参与对于确保治疗的连续性似乎至关重要。此外,有效的临床沟通至关重要,影响着患者护理和跨专业协作的各个方面,需要不断适应以满足不同患者群体不断变化的需求。

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