Organization of medical rehabilitation: gaps and solutions
https://doi.org/10.17749/2949-5873/rehabil.2024.30
Abstract
Background. Rehabilitation services are an essential part of modern healthcare systems. Despite the achieved technological progress in medical care, gaps in the organization of effective medical rehabilitation remain unresolved.
Objective: review of current approaches to organizing effective medical rehabilitation services.
Material and methods. The search for sources published over the period of last 10 years was conducted using PubMed/ MEDLINE, Google Scholar, Science Direct, eLibrary and CyberLeninka databases. The search for documents related to the regulation of rehabilitation care was carried out using the Yandex and Google search engines. Individual references included in review articles were studied in greater detail. The selection procedure conducted in accordance with the PRISMA recommenda- tions retrieved 35 publications.
Results. The current recommendations given by World Health Organization experts were presented. The state of rehabilitation services in Russia and the experience of organizing rehabilitation services abroad were analyzed. The shortcomings of existing rehabilitation approaches were identified, along with issues related to accessibility of medical care. Gaps in legislation were indicated, and innovative technologies for solving issues with the provision of rehabilitation support were described.
Conclusion. The existing systems of providing rehabilitation services in different countries are associated with certain short- comings. In this connection, countries and research groups continue to develop schemes for optimizing the load on rehabilitation services.
About the Authors
A. Aleksandrov
Institute for Preventive and Social Medicine; “Pharmacogen” Center for Preclinical Research
Russian Federation
Russian Federation
Andrey G. Aleksandrov, PhD
4/10 Sadovaya-Triumfalnaya Str., Moscow 127006
84B Bykov Str., Leningrad Region, Vsevolozhsk District, Koltushskoye Rural Settlement, Pavlovo 188680
O. A. Obukhova
Blokhin National Medical Research Center of Oncology
Russian Federation
Russian Federation
Olga A. Obukhova, PhD
24 Kashirskoe Shosse, Moscow 115522
References
1. Rehabilitation. World Health Organization. 2024. Available at: https://www.who.int/news-room/fact-sheets/detail/rehabilitation (accessed 30.04.2024).
2. Sustainable Development Goals. Goal 3: Ensure healthy lives and promote well-being for all at all ages. United Nations. Available at: https://www.un.org/sustainabledevelopment/health/ (accessed 30.04.2024).
3. Kim Y.V. Aftertreatment of patients with lesions of a nervous system (the review of literature). Herald of Almaty State Institute of Advanced Medical Education. 2013; S3: 90–2 (in Russ.).
4. Martinov Y.S., Lebedeva L.A., Shenderovich M.P., et al. Rehabilitation in neurology: now and in perspective. RUDN Journal of Medicine. 2007; 3: 71–6 (in Russ.).
5. Rehabilitation in health systems. Geneva: World Health Organization; 2017. Available at: https://www.ncbi.nlm.nih.gov/books/NBK552492/ (accessed 30.04.2024).
6. Order of the Ministry of Health of the RF dated 31.07.2020 No. 788n “On approval of the Procedure for organizing medical rehabilitation of adults”. Available at: http://publication.pravo.gov.ru/Document/View/0001202009250036 (in Russ.) (accessed 30.04.2024).
7. Order of the Ministry of Health of the RF dated 23.10.2019 No. 878n “On approval of the Procedure for organizing medical rehabilitation of children”. Available at: http://publication.pravo.gov.ru/Document/View/0001201912240050 (in Russ.) (accessed 30.04.2024).
8. Order of the Ministry of Health of the RF dated 28.02.2023 No 81n “On approval of the procedure for organizing medical rehabilitation at home, including a list of medical interventions provided during medical rehabilitation at home, the procedure for providing medical devices to the patient and the procedure for paying for medical rehabilitation at home”. Available at: http://publication.pravo.gov.ru/Document/View/0001202303300018 (in Russ.) (accessed 03.06.2024).
9. Ivanova G.E. Medical rehabilitation in Russia. Development prospects. Consilium Medicum. 2016; 18 (2.1): 9–13 (in Russ.).
10. Builova T.V., Bolotov D.D. Organization of rehabilitation process in patients after limb amputations from the position of physical and rehabilitation medicine modern concept. Bulletin of Rehabilitation Medicine. 2020; 96 (2): 7–12 (in Russ.). https://doi.org/10.38025/2078-1962-2020-96-2-7-12.
11. Kamkin E.G. On the implementation of the federal project “Optimal medical rehabilitation for restoring health”. Analytical Bulletin of the Federation Council of the Federal Assembly of the RF. 2023; 12: 9–15 (in Russ.).
12. Decision of the Council for Regional Health Care under the Federation Council of the Federal Assembly of the Russian Federation following a meeting on the topic “New technologies in medical rehabilitation: opportunities and prospects”. Analytical Bulletin of the Federation Council of the Federal Assembly of the RF. 2023; 12: 47–57 (in Russ.).
13. Danilova N.V. Problems with providing specialized (rehabilitation) aid in medical organizations. Manager zdravoohranenia. 2014; 10: 33–9 (in Russ.).
14. Bidenko M.A., Bortnik O.V. The experience of organizing the department of the second stage of medical rehabilitation of patients with stroke. Bulletin of Rehabilitation Medicine. 2019; 1: 10–5 (in Russ.).
15. Kravchuk S.G. Medical rehabilitation within the framework of compul- sory health insurance programs. Analytical Bulletin of the Federation Council of the Federal Assembly of the RF. 2023; 12: 22–5 (in Russ.).
16. Aksenova E.I., Andreev D.A., Andrusov V.E. et al. Current approaches to the formation of rehabilitation systems: a review of foreign experience. Available at: https://niioz.ru/upload/iblock/f38/f3816134fddc0ad45f546c99bdcbf7dc.pdf (in Russ.) (accessed 30.04.2024).
17. Law of the People’s Republic of China on Basic Medical and Health Care and the Promotion of Health. Ministry of Justice of the People's Republic of China. Available at: http://en.moj.gov.cn/2021-06/26/c_636455.htm (accessed 05.05.2024). Law of the People’s Republic of China on Basic Medical and Health Care and the Promotion of Health. Ministry of Justice of the People's Republic of China. Available at: http://en.moj.gov.cn/2021-06/26/c_636455.htm (accessed 05.05.2024).
18. China to promote national health during 14th Five-Year Plan. The State Council of the People's Republic of China. Available at: https://english.www.gov.cn/policies/latestreleases/202205/20/content_WS62874295c6d02e533532b0bd.html (accessed 05.05.2024).
19. Outline of the 14th Five-Year Plan (2021–2025) for National Economic and Social Development and Vision 2035 of the People's Republic of China. Available at: https://faolex.fao.org/docs/pdf/chn205796.pdf (accessed 05.05.2024).
20. Xiao Y., Zhao K., Ma Z.X., et al. Integrated medical rehabilitation delivery in China. Chronic Dis Transl Med. 2017; 3 (2): 75–81. https://doi.org/10.1016/j.cdtm.2017.02.003.
21. Zhou M., Dong E. Opportunity and challenge of rehabilitation medicine in China. Med Rev. 2024; 4 (2): 87–9. https://doi.org/10.1515/mr-2024-0027.
22. One-Rehab: Enabling shared care across the patient rehabilitation journey. Available at: https://moht.com.sg/one-rehab-enablingshared-care-across-the-patient-rehabilitation-journey/ (accessed 05.05.2024).
23. Comparison of integrated shield plans. The Ministry of Health of Singapore. Available at: https://www.moh.gov.sg/healthcareschemes-subsidies/medishield-life/comparison-of-integrated-shieldplans (accessed 05.05.2024).
24. MediShield Life. The Ministry of Health of Singapore. Available at: https://www.moh.gov.sg/healthcare-schemes-subsidies/medishieldlife (accessed 05.05.2024).
25. Public Law 111-148 – Patient Protection and Affordable Care Act. Available at: https://www.govinfo.gov/app/details/PLAW-111publ148 (accessed 05.05.2024).
26. Inpatient Rehabilitation Care Coverage. Medicare, 2024. Available at: https://www.medicare.gov/coverage/inpatient-rehabilitation-care (accessed 05.05.2024).
27. Compilation of the Social Security Laws. Social Security. Available at: https://www.ssa.gov/OP_Home/ssact/ssact-toc.htm (accessed 05.05.2024).
28. Нечаев В.С., Магомедова В.С. Организация медицинской реабилитации за рубежом: аналитический обзор. Проблемы социальной гигиены, здравоохранения и истории медицины. 2017; 25 (3): 175–7. Nechaev V.S., Magomedova Z.A. The organization of medical rehabilitation abroad: an analytical review. Problems of Social Hygiene, Public Health and History of Medicine. 2017; 25 (3): 175–7 (in Russ.).
29. Ekusheva E.V., Shavlovskaya O.A., Damulin I.V. The optimization of rehabilitation strategies in patients with sensorimotor disorders under different levels of central nervous system damage. Russian Medical Journal. 2013; 3: 18–23 (in Russ.).
30. Bandholm T., Wainwright T.W., Kehlet H. Rehabilitation strategies for optimisation of functional recovery after major joint replacement. J Exp Orthop. 2018; 5: 44. https://doi.org/10.1186/s40634-018-0156-2.
31. Aizenshtein A.D., Trofimova A.K., Mikadze Yu.V., Ivanova G.E. Methodological problems of psychometric tests in clinical studies of cognitive disorders in patients with cerebral vascular lesions: a review. Bulletin of Rehabilitation Medicine. 2023; 22 (1): 46–59 (in Russ.). https://doi.org/10.38025/2078-1962-2023-22-1-46-59.
32. Loginova O.V., Bovtyuk D.I. Rehabilitation of patients with post-stroke dysarthria in the Russia and abroad: a literature review. Bulletin of Rehabilitation Medicine. 2023; 22 (6): 100–6 (in Russ.). https://doi.org/10.38025/2078-1962-2023-22-6-100-106.
33. Ansokova M.A., Rozanov I.A., Marchenkova L.A. Advanced application of digital technologies for rehabilitation and remote monitoring of patients with post-covid syndrom: a review. Bulletin of Rehabilitation Medicine. 2023; 22 (1): 117–23 (in Russ.). https://doi.org/10.38025/2078-1962-2023-22-1-117-123.
34. Choi Y.H., Paik N.J. Mobile game-based virtual reality program for upper extremity stroke rehabilitation. J Vis Exp. 2018; 133: 56241. https://doi.org/10.3791/56241.
Review
For citations:
Aleksandrov A., Obukhova O.A. Organization of medical rehabilitation: gaps and solutions. Journal of Medical Rehabilitation. 2024;2(3):295-302. (In Russ.) https://doi.org/10.17749/2949-5873/rehabil.2024.30
Views:
251
Email this article 