Journal articles on the topic 'Insurance-based rehabilitation'
To see the other types of publications on this topic, follow the link: Insurance-based rehabilitation.
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Insurance-based rehabilitation.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
HAMAMURA, Akinori. "Promotion of Community Based Rehabilitation Including Care Insurance System." Japanese Journal of Rehabilitation Medicine 36, no. 6 (1999): 377–80. http://dx.doi.org/10.2490/jjrm1963.36.377.
Full text
2
Tung, Yu-Ju, Wen-Chih Lin, Lin-Fu Lee, Hong-Min Lin, Chung-Han Ho, and Willy Chou. "Comparison of Cost-Effectiveness between Inpatient and Home-Based Post-Acute Care Models for Stroke Rehabilitation in Taiwan." International Journal of Environmental Research and Public Health 18, no. 8 (April 14, 2021): 4129. http://dx.doi.org/10.3390/ijerph18084129.
Full textAbstract:
Stroke rehabilitation focuses on alleviating post-stroke disability. Post-acute care (PAC) offers an intensive rehabilitative program as transitional care following acute stroke. A novel home-based PAC program has been initiated in Taiwan since 2019. Our study aimed to compare the current inpatient PAC model with a novel home-based PAC model in cost-effectiveness and functional recovery for stroke patients in Taiwan. One hundred ninety-seven stroke patients eligible for the PAC program were divided into two different health interventional groups. One received rehabilitation during hospitalization, and the other received rehabilitation by therapists at home. To evaluate the health economics, we assessed the total medical expenditure on rehabilitation using the health system of Taiwan national health insurance and performed cost-effectiveness analyses using improvements of daily activity in stroke patients based on the Barthel index (BI). Total rehabilitative duration and functional recovery were also documented. The total rehabilitative cost was cheaper in the home-based PAC group (p < 0.001), and the cost-effectiveness is USD 152.474 ± USD 164.661 in the inpatient group, and USD 48.184 ± USD 35.018 in the home group (p < 0.001). Lesser rehabilitative hours per 1-point increase of BI score was noted in the home-PAC group with similar improvements in daily activities, life quality and nutrition in both groups. Home-based PAC is more cost-effective than inpatient PAC for stroke rehabilitation.
3
Buys, Nicholas, and Elizabeth Kendall. "Stress and Burnout Among Rehabilitation Counsellors Within the Context of Insurance-Based Rehabilitation: An Institutional-Level Analysis." Australian Journal of Rehabilitation Counselling 4, no. 1 (1998): 1–12. http://dx.doi.org/10.1017/s1323892200001344.
Full textAbstract:
Work stress and burnout are common problems in rehabilitation services. Usually, attempts to account for stress and burnout focus on the qualities of the individual and the demands of the organisational environment. However, the current paper has responded to recent demands in the occupational stress literature to examine burnout from a third perspective, namely the institutional level. This level of analysis transcends the boundaries of organisations and can be defined by the various political, economic, social and legal constraints that characterise a broad area. It is argued that the rapid growth of insurance-based rehabilitation in Australia has created a unique institutional context that has significant implications for the development of stress and burnout among rehabilitation counsellors. Rehabilitation counsellors in this context face a diverse array of conflicting demands within a system that often does not support the goals of rehabilitation. It is proposed that the development of strategies to reduce stress and burnout in this area would benefit from an institutional-level analysis. While individualised stress management training clearly has a role in the minimisation of stress and burnout, it is proposed in the current paper that this issue has human resource management and educational implications that must be addressed.
4
Cho, Joongbum, Hyejeong Park, Danbee Kang, Esther Park, Chi Ryang Chung, Juhee Cho, and Sapna R. Kudchadkar. "Rehabilitation in critically ill children: Findings from the Korean National Health Insurance database." PLOS ONE 17, no. 3 (March 31, 2022): e0266360. http://dx.doi.org/10.1371/journal.pone.0266360.
Full textAbstract:
Purpose Intensive care unit (ICU) survivors suffer from physical weakness and challenges returning to daily life. With the importance of rehabilitating patients in the pediatric intensive care unit being increasingly recognized, we evaluated the prevalence of physical and occupational therapy (PT/OT)-provided rehabilitation and factors affecting its use. Methods We conducted a retrospective cohort analysis of rehabilitation between 2013 and 2019 using the Korean National Health Insurance database. All patients aged 28 days to 18 years who had been admitted to 245 ICUs for more than 2 days were included. Neonatal ICUs were excluded. Results Of 13,276 patients, 2,447 (18%) received PT/OT-provided rehabilitation during their hospitalization; prevalence was lowest for patients younger than 3 years (11%). Neurologic patients were most likely to receive rehabilitation (adjusted odds ratio [aOR], 6.47; 95% confidence interval [CI], 5.11–8.20). Longer ICU stay (versus ≤ 1 week) was associated with rehabilitation (aOR for 1–2 weeks, 3.50 [95% CI, 3.04–4.03]; 2–3 weeks, 6.60 [95% CI, 5.45–8.00]; >3 weeks, 13.69 [95% CI, 11.46–16.35]). Mechanical ventilation >2 days (aOR, 0.78; 95% CI, 0.67–0.91) and hemodialysis (aOR, 0.50; 95% CI, 0.41–0.52) were negatively affecting factors. Conclusion Prevalence of rehabilitation for critically ill children was low and concentrated on patients with a prolonged ICU stay. The finding that mechanical ventilation, a risk factor for ICU-acquired weakness, was an obstacle to rehabilitation highlights the need for studies on early preventive rehabilitation based on individual patient needs.
5
Liu, Xinliang, William J. Hanney, Michael Masaracchio, and Morey J. Kolber. "Utilization and Payments of Office-Based Physical Rehabilitation Services Among Individuals With Commercial Insurance in New York State." Physical Therapy 96, no. 2 (February 1, 2016): 202–11. http://dx.doi.org/10.2522/ptj.20150060.
Full textAbstract:
BackgroundLimited research exists on the utilization and payments of physical rehabilitation services, especially among individuals with commercial insurance.ObjectiveThis study aimed to characterize the utilization and payments of office-based physical rehabilitation services among nonelderly individuals with commercial insurance from New York State.DesignThis was a retrospective descriptive study with a cross-sectional design.MethodsA cohort of 1.8 million individuals in the 2012 Truven Health MarketScan Research Database was constructed for review. A total of 109,821 unique patients who received any type of physical rehabilitation provided by physical therapists, chiropractors, and physicians in the office setting were included for analyses.ResultsPhysical therapists provided the largest proportion of physical rehabilitation services (54.5%), followed by chiropractors (27.5%) and physicians (18.0%). Six out of 100 individuals used physical rehabilitation services in 2012. The mean annual payment of physical rehabilitation per patient was $820 (median=$323). Women and older individuals were more likely to use rehabilitation services and have higher annual utilization and payments. For the 5 most common physical rehabilitation services, payment rates for chiropractors were the highest and those for physical therapists were the lowest, with payment rates for physicians in between.LimitationsThis study was based on commercial insurance claims data from one state.ConclusionsFindings from this study recognize that rehabilitation services are delivered by various types of health care professionals and the payment rates vary across provider specialties in New York State. Of particular interest is that although physical therapists provide the largest proportion of services, their payment rates are lower than the rates for chiropractors and physicians. Future research should assess regional variations and explore interprovider cost-effectiveness in delivering these interventions.
6
HANAOKA, Toshiyasu, Kaoru KURIHARA, Yasuko HINATA, Michiko SATO, Michiko KUBOTA, Toshihide TORIYAMA, and Akira KANAI. "The Influence of Newly Introduced Nursing Care Insurance System on Community-Based Rehabilitation." JOURNAL OF THE JAPANESE ASSOCIATION OF RURAL MEDICINE 52, no. 1 (2003): 90–94. http://dx.doi.org/10.2185/jjrm.52.90.
Full text
7
Jo, Leechan. "Trend of Pediatric Rehabilitation Therapy Based on Health Insurance Review and Assessment Service Data." Archives of Physical Medicine and Rehabilitation 98, no. 4 (April 2017): e5. http://dx.doi.org/10.1016/j.apmr.2017.01.005.
Full text
8
Bonakdar, Robert, Dania Palanker, and Megan M. Sweeney. "Analysis of State Insurance Coverage for Nonpharmacologic Treatment of Low Back Pain as Recommended by the American College of Physicians Guidelines." Global Advances in Health and Medicine 8 (January 2019): 216495611985562. http://dx.doi.org/10.1177/2164956119855629.
Full textAbstract:
Background In 2017, the American College of Physicians (ACP) released guidelines encouraging nonpharmacologic treatment of chronic low back pain (LBP). These guidelines recommended utilization of treatments including multidisciplinary rehabilitation, acupuncture, mindfulness-based stress reduction (MBSR), tai chi, yoga, progressive relaxation, biofeedback, cognitive behavioral therapy (CBT), and spinal manipulation. Objective We aimed to determine status of insurance coverage status for multiple nonpharmacological pain therapies based on the 2017 Essential Health Benefits (EHB) benchmark plans across all states. Methods The 2017 EHB benchmark plans represent the minimum benefits required in all new policies in the individual and small group health insurance markets and were reviewed for coverage of treatments for LBP recommended by the ACP guidelines. Additionally, plans were reviewed for limitations and exclusionary criteria. Results In nearly all state-based coverage policies, chronic pain management and multidisciplinary rehabilitation were not addressed. Coverage was most extensive (supported by 46 states) for spinal manipulation. Acupuncture, massage, and biofeedback were each covered by fewer than 10 states, while MBSR, tai chi, and yoga were not covered by any states. Behavioral health treatment (CBT and biofeedback) coverage was often covered solely for mental health diagnoses, although excluded for treating LBP. Conclusion Other than spinal manipulation, evidence-based, nonpharmacological therapies recommended by the 2017 ACP guidelines were routinely excluded from EHB benchmark plans. Insurance coverage discourages multidisciplinary rehabilitation for chronic pain management by providing ambiguous guidelines, restricting ongoing treatments, and excluding behavioral or complementary therapy despite a cohesive evidence base. Better EHB plan coverage of nondrug therapies may be a strategy to mitigate the opioid crisis. Recommendations that reflect current research-based findings are provided to update chronic pain policy statements.
9
Cottone, R. Rocco. "Toward A Systemic Theoretical Framework for Vocational Rehabilitation." Journal of Applied Rehabilitation Counseling 17, no. 4 (December 1, 1986): 4–7. http://dx.doi.org/10.1891/0047-2220.17.4.4.
Full textAbstract:
This article presents a theoretical framework for vocational rehabilitation based on social systems theory. Social systems theory provides a unifying perspective for vocational rehabilitation both from a service delivery standpoint and from a professional development standpoint. Professional issues in the public and private sectors are addressed, including insurance specialist certification and ethical standards. It is proposed that social systems theory can supplant the strongly imbedded medical and psychological models at the metatheoretical level, while complementing the other models in the study of the individual.
10
Côté, Pierre, Eleanor Boyle, Heather M. Shearer, Maja Stupar, Craig Jacobs, John David Cassidy, Simon Carette, et al. "Is a government-regulated rehabilitation guideline more effective than general practitioner education or preferred-provider rehabilitation in promoting recovery from acute whiplash-associated disorders? A pragmatic randomised controlled trial." BMJ Open 9, no. 1 (January 2019): e021283. http://dx.doi.org/10.1136/bmjopen-2017-021283.
Full textAbstract:
ObjectiveTo evaluate the effectiveness of a government-regulated rehabilitation guideline compared with education and activation by general practitioners, and to a preferred-provider insurance-based rehabilitation programme on self-reported global recovery from acute whiplash-associated disorders (WAD) grade I–II.DesignPragmatic randomised clinical trial with blinded outcome assessment.SettingMultidisciplinary rehabilitation clinics and general practitioners in Ontario, Canada.Participants340 participants with acute WAD grade I and II. Potential participants were sampled from a large automobile insurer when reporting a traffic injury.InterventionsParticipants were randomised to receive one of three protocols: government-regulated rehabilitation guideline, education and activation by general practitioners or a preferred-provider insurance-based rehabilitation.Primary and secondary outcome measuresOur primary outcome was time to self-reported global recovery. Secondary outcomes included time on insurance benefits, neck pain intensity, whiplash-related disability, health-related quality of life and depressive symptomatology at 6 weeks and 3, 6, 9 and 12 months postinjury.ResultsThe median time to self-reported global recovery was 59 days (95% CI 55 to 68) for the government-regulated guideline group, 105 days (95% CI 61 to 126) for the preferred-provider group and 108 days (95% CI 93 to 206) for the general practitioner group; the difference was not statistically significant (Χ2=3.96; 2 df: p=0.138). We found no clinically important differences between groups in secondary outcomes. Post hoc analysis suggests that the general practitioner (hazard rate ratio (HRR)=0.51, 95% CI 0.34 to 0.77) and preferred-provider groups (HRR=0.67, 95% CI 0.46 to 0.96) had slower recovery than the government-regulated guideline group during the first 80 days postinjury. No major adverse events were reported.ConclusionsTime-to-recovery did not significantly differ across intervention groups. We found no differences between groups with regard to neck-specific outcomes, depression and health-related quality of life.Trial registration numberNCT00546806.
11
Hartley, Michael T., and Brenda Y. Cartwright. "A Survey of Current and Projected Ethical Dilemmas of Rehabilitation Counselors." Rehabilitation Research, Policy, and Education 30, no. 1 (2016): 32–47. http://dx.doi.org/10.1891/2168-6653.30.1.32.
Full textAbstract:
Purpose:This study surveyed current and projected ethical dilemmas of rehabilitation counselors.Method:As a mixed-methods approach, the study used both quantitative and qualitative analyses.Results:Of the 211 participants who completed the survey, 116 (55.0%) reported an ethical dilemma. Based on the descriptions, common themes involved roles and relationships with clients, professional responsibility and competence, and confidentiality and privacy. In addition, projected dilemmas involved social media, health care legislation, insurance concerns, and professional competence.Conclusions:Implications address areas for ongoing discussion, including considerations for future revisions to the Commission on Rehabilitation Counselor Certification Code of Ethics.
12
Meagher, Ashley D., Christopher A. Beadles, Jennifer Doorey, and Anthony G. Charles. "Racial and ethnic disparities in discharge to rehabilitation following traumatic brain injury." Journal of Neurosurgery 122, no. 3 (March 2015): 595–601. http://dx.doi.org/10.3171/2014.10.jns14187.
Full textAbstract:
OBJECT Disparities in access to inpatient rehabilitation services after traumatic brain injury (TBI) have been identified, but less well described is the likelihood of discharge to a higher level of rehabilitation for Hispanic or black patients compared with non-Hispanic white patients. The authors investigate racial disparities in discharge destination (inpatient rehabilitation vs skilled nursing facility vs home health vs home) following TBI by using a nationwide database and methods to address racial differences in prehospital characteristics. METHODS Analysis of discharge destination for adults with moderate to severe TBI was performed using National Trauma Data Bank data for the years 2007–2010. The authors performed propensity score weighting followed by ordered logistic regression in their analytical sample and in a subgroup analysis of older adults with Medicare. Likelihood of discharge to a higher level of rehabilitation based on race/ethnicity accounting for prehospital and in-hospital variables was determined. RESULTS The authors identified 299,205 TBI incidents: 232,392 non-Hispanic white, 29,611 Hispanic, and 37,202 black. Propensity weighting resulted in covariate balance among racial groups. Hispanic (adjusted OR 0.71, 95% CI 0.68–0.75) and black (adjusted OR 0.94, 95% CI 0.91–0.97) populations were less likely to be discharged to a higher level of rehabilitation than were non-Hispanic whites. The subgroup analysis indicated that Hispanic (adjusted OR 0.79, 95% CI 0.71–0.86) and black (OR 0.87, 95% CI 0.81–0.94) populations were still less likely to receive a higher level of rehabilitation, despite uniform insurance coverage (Medicare). CONCLUSIONS Adult Hispanic and black patients with TBI are significantly less likely to receive intensive rehabilitation than their non-Hispanic white counterparts; notably, this difference persists in the Medicare population (age ≥ 65 years), indicating that uniform insurance coverage alone does not account for the disparity. Given that insurance coverage and a wide range of prehospital characteristics do not eliminate racial disparities in discharge destination, it is crucial that additional unmeasured patient, physician, and institutional factors be explored to eliminate them.
13
Trolley, Barbara C. "The Use of Active Learning Strategies in Teaching Rehabilitation Counselors Clinical Skills." Journal of Applied Rehabilitation Counseling 27, no. 2 (June 1, 1996): 46–52. http://dx.doi.org/10.1891/0047-2220.27.2.46.
Full textAbstract:
Important to the clinical training of rehabilitation counselors is the development of communication skills and the opportunity to process therapeutic experiences. Of equal value is the provision of concrete clinical tools to these counselors, and the chance for them to practice their skills and integrate what they've learned into their own internal frame of reference. Activities and tasks, based on active learning principles, facilitate critical thinking and expose these students to a variety of clinical topics. This holistic approach to teaching rehabilitation counselors clinical skills can aid in making them more competitive in this time of managed care, short term therapy, and services based on insurance reimbursement.
14
KNEISLER, Olha, and Lesia SHUPA. "OPTIMIZATION PRICING IN THE MARKET FOR VOLUNTARY HEALTH INSURANCE." WORLD OF FINANCE, no. 3(52) (2017): 7–18. http://dx.doi.org/10.35774/sf2017.03.007.
Full textAbstract:
Introduction. The modern market of voluntary health insurance is not able to cover a significant number of insurers. This means that insurance companies seek to attract a client among people at risk lower than the average, and, accordingly, reject the proposals for the insurance coverage of applicants with a risk level that is higher than the average. Purpose. In connection with the stated actual task the question arises the formation of scientifically-based insurance tariffs, which will ensure both the break-even activity of the insurance company, and the availability of insurance services for the largest possible population. Results. The question of the use of reasonable pricing in view of determining the correct and flexible cost of treatment and health rehabilitation, is a complex and important task for each insurer. Tariffs offered by insurers on the market should be calculated both from the actuarial and from the marketing point of view. Formation of optimal, scientifically substantiated and practically verified flexible pricing for voluntary medical insurance will improve the quality of medical care of the population, the creation of guarantees of reliable insurance protection and state interests. Conclusion. In order to optimize pricing a scientific and methodical approach to the formation of a flexible system of insurance tariffs with the use of the reliability theory of computational results modeled by Bülman-Straub is proposed. It is proved that the Bülman-Straub model, based on the determination of the confidence coefficient Z, allows us to assess the reliability of statistical information in the calculations and to determine the optimal amount of the insurance tariff for voluntary health insurance.
15
Singh, Jasvinder A., and John D. Cleveland. "Insurance Payer Type and Patient Income Are Associated with Outcomes after Total Shoulder Arthroplasty." Journal of Rheumatology 47, no. 4 (June 1, 2019): 589–96. http://dx.doi.org/10.3899/jrheum.190287.
Full textAbstract:
Objective.To assess the independent association of insurance and patient income with total shoulder arthroplasty (TSA) outcomes.Methods.We used the 1998–2014 US National Inpatient Sample. We used multivariable-adjusted logistic regression to examine whether insurance type and the patient’s median household income (based on postal code) were independently associated with healthcare use (discharge destination, hospital stay duration, total hospital charges) and in-hospital complications post-TSA based on the diagnostic codes (fracture, infection, transfusion, or revision surgery). We calculated the OR and 95% CI.Results.Among the 349,046 projected TSA hospitalizations, the mean age was 68.6 years, 54% were female, and 73% white. Compared to private insurance, Medicaid and Medicare (government insurance) users were associated with significantly higher adjusted OR (95% CI) of (1) discharge to a rehabilitation facility, 2.16 (1.72–2.70) and 2.27 (2.04–2.52); (2) hospital stay > 2 days, 1.65 (1.45–1.87) and 1.60 (1.52–1.69); and (3) transfusion, 1.35 (1.05–1.75) and 1.39 (1.24–1.56), respectively. Medicaid was associated with a higher risk of fracture [1.74 (1.07–2.84)] and Medicare user with a higher risk of infection [2.63 (1.24–5.57)]; neither were associated with revision. Compared to the highest income quartile, the lowest income quartile was significantly associated with (OR, 95% CI): (1) discharge to a rehabilitation facility (0.89, 0.83–0.96); (2) hospital stay > 2 days (0.84, 0.80–0.89); (3) hospital charges above the median (1.19, 1.14–1.25); (4) transfusion (0.73, 0.66–0.81); and (5) revision (0.49, 0.30–0.80), but not infection or fracture.Conclusion.This information can help to risk-stratify patients post-TSA. Future assessments of modifiable mediators of these complications are needed.
16
Kovács, Gábor. "A rokkantság, megváltozott munkaképesség, rehabilitációs ellátások változása Magyarországon 1990 és 2015 között." Orvosi Hetilap 160, Supplement 1 (February 2019): 29–36. http://dx.doi.org/10.1556/650.2019.31372.
Full textAbstract:
Introduction: In our study, based on the data of the last 25 years, we analyzed the changes in the cash benefits paid to people with reduced working capacity, currently accounting for nearly 30% of the budget of the National Health Insurance Fund of Hungary. Aim: The purpose of our study is to compare the statistical data of the past 25 years and the changes in the legal environment. Methods: Our research was based on the data series of the National Health Insurance Fund of Hungary and the Hungarian Central Statistical Office as well as on the public finance reports of the State Audit Office of Hungary and the Ministry for National Economy. For the period under review, we analyzed the extent of the cash benefits paid to people with reduced working capacity, the measures taken to reduce these benefits, and the related legal background. In the long term, we examined the relevant dimension of the complex sociological processes in the background as well as the medical evaluation of the changed working ability. Results: In the last 25 years, benefits (annuity, retirement) paid under different denominations (disability, work ability reduction, health impairment, rehabilitation benefit) are still a decisive part of the health insurance budget (HUF 315 billion in 2016). Serious efforts have been made to replace the previously funded system of invalidity pension and annuity system, with the complex medical, occupational, and social rehabilitation, maintenance and improvement of the remaining state of health. The purpose of the measures is essentially to reduce budget expenditures and to improve the utilization of the amount paid on rehabilitation benefits. Conclusion: The sociological changes that occurred during the long period of time regrettably helped to initially increase the number of recipients of invalidity benefits, to stabilize them at a high level and to have a significant burden on the budget. This could not be counterbalanced by the rehabilitation approach of money supply either. Orv Hetil. 2019; 160(Suppl 1): 29–36.
17
Wulff, Stephen. "Flipping the “New Penology” Script: Police Misconduct Insurance, Grassroots Activism, and Risk Management–Based Reform." Law & Social Inquiry 47, no. 1 (December 17, 2021): 162–204. http://dx.doi.org/10.1017/lsi.2021.64.
Full textAbstract:
Through a multi-method qualitative case study, I examine the failed 2016 ballot campaign of the Committee for Professional Policing (CfPP), a police accountability group in Minneapolis, Minnesota. In attempting to make Minneapolis the first city nationwide to require police to carry professional liability insurance, the CfPP turned the logic of Malcolm M. Feeley and Jonathan Simon’s “new penology” paradigm onto police. Their thesis argues that a contemporary penal shift occurred away from rehabilitation toward managing aggregates of dangerous criminal categories through risk management approaches. I extend their thesis in a new direction by examining how—in the emerging age of “algorithmic risk governance”—social movement organizations, like the CfPP, are starting to invert the new penology onto criminal justice personnel. In flipping the script, the CfPP called for a new private insurance market using mandatory police misconduct insurance to manage aggregates of dangerous police officers. After highlighting how the CfPP developed new penological objectives, discourses, and technologies, I discuss the implications of grassroots groups adopting and redefining traditional penal logics and propose future research avenues.
18
Pergolotti, Mackenzi, Jessica A. Lavery, Bryce B. Reeve, and Stacie Dusetzina. "The financial burden of rehabilitation: Variation in clinician charges and implications for patient financial liability." Journal of Clinical Oncology 32, no. 30_suppl (October 20, 2014): 40. http://dx.doi.org/10.1200/jco.2014.32.30_suppl.40.
Full textAbstract:
40 Background: Occupational and Physical therapies (OT/PT) are effective treatments to decrease disability and functional status. Few studies have examined the variations in the cost of outpatient OT/PT. For adults with cancer, the added financial burden of cancer rehabilitation is unknown. The study objectives were to (1) describe the variation in patient financial burden for the most commonly used OT/PT services by the provider type (either OT or PT) and State; and (2) determine the impact of therapy caps on the price of service provided among Medicare beneficiaries. Methods: This retrospective, population-based study used the Medicare Provider Utilization and Payment Data Public Use File (PUF), released in April 2014 by the Center for Medicare and Medicaid Services (CMS) to examine variations in care by level of insurance (uninsured, insured and reimbursed), between providers and across states with descriptive statistics. We also examined the impact of the therapy cap on number of visits allowed and the proposed reduction of the therapy cap dollar amount on services use and patient out-of-pocket liability. Results: 3,663 (9.2%) OT’s and 36,247 (90.8%) PT’s were included. Differences between provider’s charges were minimal. Wisconsin, Illinois, Tennessee and Texas had the most inflated charges, respectively, for OT and PT. 12-14 visits plus evaluation are covered under 2012 therapy cap, and the amount of visits would be cut to 7-9 with the MedPAC cap. Conclusions: This study suggests there is wide variation between the potential patient liability for the price of OT/PT based on service provided, state received and insurance coverage. For older adults with cancer who need OT/PT services, this will be an additional cost to their care. Patients without insurance pay a premium for OT/PT services.
19
Freburger, Janet K., and George M. Holmes. "Physical Therapy Use by Community-Based Older People." Physical Therapy 85, no. 1 (January 1, 2005): 19–33. http://dx.doi.org/10.1093/ptj/85.1.19.
Full textAbstract:
Abstract Background and Purpose. Little information is available on factors associated with physical therapy use. Identifying the characteristics of people who use physical therapy and some of the factors associated with its use is a useful first step in determining whether disparities exist in physical therapy use. The purpose of this study was to identify factors associated with physical therapy use by community-based older people. Subjects. The subjects were community-based people 65 years of age or older who participated in the Medicare Current Beneficiary Survey and had at least one physician encounter (N=38,312 person-years across 20,227 individuals). Methods. Logit and ordinary least squares regression analyses were conducted to identify factors associated with physical therapy use. Results. Several measures of health and function were associated with physical therapy use. Several demographic, insurance, and geographic characteristics also were associated with physical therapy use. Income, education, having supplemental private insurance, participating in a managed care plan, and physical therapist supply were positively associated with physical therapy use. Age was negatively associated with physical therapy use. For people who saw a physical therapist, amount of physical therapy received was positively associated with income, having supplemental private insurance, living in a metropolitan area, physical therapist supply, and being African American. Amount of physical therapy received was negatively associated with being in a managed care plan. Discussion and Conclusions. Variation in physical therapy use, explained by factors other than need, suggests potential underuse or overuse of physical therapy by community-based older people.
20
Papagiannaki, Katerina, Vassiliki Kotroni, Kostas Lagouvardos, Antonis Bezes, Vasileios Vafeiadis, Ioanna Messini, Efstathios Kroustallis, and Ioannis Totos. "Identification of Rainfall Thresholds Likely to Trigger Flood Damages across a Mediterranean Region, Based on Insurance Data and Rainfall Observations." Water 14, no. 6 (March 21, 2022): 994. http://dx.doi.org/10.3390/w14060994.
Full textAbstract:
Flood-producing rainfall amounts have a significant cumulative economic impact. Despite the advance in flood risk mitigation measures, the cost of rehabilitation and compensation of citizens by the state and insurance companies is increasing worldwide. A continuing challenge is the flood risk assessment based on reliable hazard and impact measures. The present study addresses this challenge by identifying rainfall thresholds likely to trigger economic losses due to flood damages to properties across the Athens Metropolitan Area of Greece. The analysis uses eight-year rainfall observations from 66 meteorological stations and high spatial resolution insurance claims on the postal code segmentation. Threshold selection techniques were applied based on the ROC curves widely used to assess the performance of binary response models. The model evaluates the probability of flood damages in terms of insurance claims in this case. Thresholds of 24-h rainfall were identified at the municipal level, as municipalities are the first administration level where decision making to address the local risks for the citizens is needed. The rainfall thresholds were further classified to estimate and map the local risk of flood damages. Practical implications regarding the applicability of the detected thresholds in early-warning systems are also discussed.
21
Masakado, Yoshihisa, and Naoichi Chino. "The Current State of Stroke Rehabilitation in Japan." Neurorehabilitation and Neural Repair 13, no. 4 (December 1999): 219–23. http://dx.doi.org/10.1177/154596839901300403.
Full textAbstract:
This paper presents the current state of stroke rehabilitation in Japan. The Japanese rehabilitation system is much different from those in other countries, mainly because of the Japanese insurance system, which covers from acute to chronic conditions. In this situation, a Japanese inpatient stroke rehabilitation program treats patients until they reach a plateau in impairment and disability. Thus we can evaluate the true func tional prognosis because of longer periods of observation for assessing the recovery pat tern of impairment and disability. As a result, we can predict stroke outcome much more precisely. We recently developed a new evaluation methods for stroke patients called the Stroke Impairment Assessment Set (SIAS) based on work from the Sym posium on Methodologic Issues in Stroke Outcome Research in 1989. Using the SIAS and the Functional Independence Measure, we have successfully predicted stroke out come using regression analysis.
22
Sandstrom, Robert W., Jedd Lehman, Lee Hahn, and Andrew Ballard. "Structure of the Physical Therapy Benefit in a Typical Blue Cross Blue Shield Preferred Provider Organization Plan Available in the Individual Insurance Market in 2011." Physical Therapy 93, no. 10 (October 1, 2013): 1342–50. http://dx.doi.org/10.2522/ptj.20120203.
Full textAbstract:
BackgroundThe Affordable Care Act of 2010 establishes American Health Benefit Exchanges. The benefit design of insurance plans in state health insurance exchanges will be based on the structure of existing small-employer–sponsored plans.ObjectiveThe purpose of this study was to describe the structure of the physical therapy benefit in a typical Blue Cross Blue Shield (BCBS) preferred provider organization (PPO) health insurance plan available in the individual insurance market in 2011.DesignA cross-sectional survey design was used.MethodsThe physical therapy benefit within 39 BCBS PPO plans in 2011 was studied for a standard consumer with a standard budget. First, whether physical therapy was a benefit in the plan was determined. If so, then the structure of the benefit was described in terms of whether the physical therapy benefit was a stand-alone benefit or part of a combined-discipline benefit and whether a visit or financial limit was placed on the physical therapy benefit.ResultsPhysical therapy was included in all BCBS plans that were studied. Ninety-three percent of plans combined physical therapy with other disciplines. Two thirds of plans placed a limit on the number of visits covered.LimitationsThe results of the study are limited to 1 standard consumer, 1 association of insurance companies, 1 form of insurance (a PPO), and 1 PPO plan in each of the 39 states that were studied.ConclusionsPhysical therapy is a covered benefit in a typical BCBS PPO health insurance plan. Physical therapy most often is combined with other therapy disciplines, and the number of covered visits is limited in two thirds of plans.
23
Joe, Caldwell, and J. Alston Reginald. "Opportunities in the Affordable Care Act to Advance Long-Term Services and Supports: The Role of Rehabilitation Counseling." Rehabilitation Research, Policy, and Education 26, no. 1 (January 2012): 55–66. http://dx.doi.org/10.1891/2168-6653.26.1.55.
Full textAbstract:
The Affordable Care Act includes many new provisions for long-term services and supports (LTSS). Among these are several new options, improvements, and incentives within Medicaid to balance service systems and expand access to home and community-based services. In addition, the Affordable Care Act authorizes the establishment of a new voluntary national long-term care insurance program, the Community Living Assistance Services and Supports (CLASS) Program. This article discusses some of the major provisions and implementation. It also examines how the major principles of rehabilitation counseling are central to advancing LTSS policy and how rehabilitation counselors can play a key role in ensuring quality LTSS services for persons with disabilities.
24
Ahmed, Tanvir, Md Assad-Uz-Zaman, Md Islam, Drew Gottheardt, Erin McGonigle, Brahim Brahmi, and Mohammad Rahman. "Flexohand: A Hybrid Exoskeleton-Based Novel Hand Rehabilitation Device." Micromachines 12, no. 11 (October 20, 2021): 1274. http://dx.doi.org/10.3390/mi12111274.
Full textAbstract:
Home-based hand rehabilitation has excellent potential as it may reduce patient dropouts due to travel, transportation, and insurance constraints. Being able to perform exercises precisely, accurately, and in a repetitive manner, robot-aided portable devices have gained much traction these days in hand rehabilitation. However, existing devices fall short in allowing some key natural movements, which are crucial to achieving full potential motion in performing activities of daily living. Firstly, existing exoskeleton type devices often restrict or suffer from uncontrolled wrist and forearm movement during finger exercises due to their setup of actuation and transmission mechanism. Secondly, they restrict passive metacarpophalangeal (MCP) abduction–adduction during MCP flexion–extension motion. Lastly, though a few of them can provide isolated finger ROM, none of them can offer isolated joint motion as per therapeutic need. All these natural movements are crucial for effective robot-aided finger rehabilitation. To bridge these gaps, in this research, a novel lightweight robotic device, namely “Flexohand”, has been developed for hand rehabilitation. A novel compliant mechanism has been developed and included in Flexohand to compensate for the passive movement of MCP abduction–adduction. The isolated and composite digit joint flexion–extension has been achieved by integrating a combination of sliding locks for IP joints and a wire locking system for finger MCP joints. Besides, the intuitive design of Flexohand inherently allows wrist joint movement during hand digit exercises. Experiments of passive exercises involving isolated joint motion, composite joint motions of individual fingers, and isolated joint motion of multiple fingers have been conducted to validate the functionality of the developed device. The experimental results show that Flexohand addresses the limitations of existing robot-aided hand rehabilitation devices.
25
Shahidi, Bahar, Jennifer Padwal, Euyhyun Lee, Ronghui Xu, Sarah Northway, Lissa Taitano, Tiffany Wu, and Kamshad Raiszadeh. "Factors impacting adherence to an exercise-based physical therapy program for individuals with low back pain." PLOS ONE 17, no. 10 (October 20, 2022): e0276326. http://dx.doi.org/10.1371/journal.pone.0276326.
Full textAbstract:
Background/Objective Exercise-based rehabilitation is a conservative management approach for individuals with low back pain. However, adherence rates for conservative management are often low and the reasons for this are not well described. The objective of this study was to evaluate predictors of adherence and patient-reported reasons for non-adherence after ceasing a supervised exercise-based rehabilitation program in individuals with low back pain. Design Retrospective observational study. Methods Data was retrospectively analyzed from 5 rehabilitation clinics utilizing a standardized exercise-based rehabilitation program. Baseline demographics, diagnosis and symptom specific features, visit number, and discontinuation profiles were quantified for 2,243 patients who underwent the program. Results Forty-three percent (43%) of participants were adherent to the program, with the majority (31.7%) discontinuing treatment prior to completion due to logistic and accessibility issues. Another 13.2% discontinued prior to the prescribed duration due to clinically significant improvements in pain and/or disability without formal discharge evaluation, whereas 8.3% did not continue due to lack of improvement. Finally, 6.0% were discharged for related and unrelated medical reasons including surgery. Individuals diagnosed with disc pathology were most likely to be adherent to the program. Limitations This study was a retrospective chart review with missing data for some variables. Future studies with a prospective design would increase quality of evidence. Conclusions The majority of individuals prescribed an in-clinic exercise-based rehabilitation program are non-adherent. Patient diagnosis was the most important predictor of adherence. For those who were not adherent, important barriers include personal issues, insufficient insurance authorization and lack of geographic accessibility.
26
Yoon, Tae-Hyung. "Inclusion of Home-based Rehabilitation Services in the Long-Term Care Insurance - Review on the Home-based Physical Therapy in the OECD -." Korean Journal of Health Service Management 5, no. 4 (December 30, 2011): 161–75. http://dx.doi.org/10.12811/kshsm.2011.5.4.161.
Full text
27
Dijksterhuis, Chris, Ben Lewis-Evans, Bart Jelijs, Oliver Tucha, Dick de Waard, and Karel Brookhuis. "In-car usage-based insurance feedback strategies. A comparative driving simulator study." Ergonomics 59, no. 9 (April 25, 2016): 1158–70. http://dx.doi.org/10.1080/00140139.2015.1127428.
Full text
28
Rinne, Hanna, and Jenni Blomgren. "Kuntoutukseen osallistuminen ja eri osajärjestelmien ristikkäiskäyttö." Kuntoutus 43, no. 4 (December 11, 2020): 6–20. http://dx.doi.org/10.37451/kuntoutus.100163.
Full textAbstract:
Tieto kuntoutuksen kentän kokonaisuudesta ja erilaisten kuntoutuspalveluiden käytöstä samoilla ihmisillä on varsin hajanaista ja puutteellista. Tutkimuksen tavoitteena on selvittää kuntoutukseen osallistumisen yleisyyttä ja päällekkäisyyttä eri osajärjestelmissä Oulun asukkailla vuonna 2018 laajalla rekisteriaineistolla (N = 192 844). Tutkimuksessa tarkastellaan julkisen sosiaali- ja terveyspalvelujärjestelmän kuntoutusta, Kelan kuntoutusta, työeläkekuntoutusta, työterveyshuollon fysioterapiaa ja Kelan korvaamaa yksityistä fysioterapiaa.
Vuonna 2018 oululaisista 18 prosenttia sai vähintään yhden tutkitun osajärjestelmän kuntoutusta (N = 34 061). Yleisintä oli julkisen sosiaali- ja terveyspalvelujärjestelmän kuntoutus, harvinaisinta työeläkekuntoutus. Naiset osallistuivat kuntoutukseen miehiä yleisemmin. Kuntoutukseen osallistuminen oli miehillä yleisintä 65 vuotta täyttäneillä, naisilla 45–64-vuotiailla. Harvinaisinta se oli 16–24-vuotiailla miehillä ja alle 16-vuotiailla naisilla. Suurin osa (90 %) kuntoutukseen osallistuneista oli osallistunut vain yhden osajärjestelmän kuntoutukseen. Useamman osajärjestelmän kuntoutukseen osallistuminen oli naisilla miehiä yleisempää. Ikäryhmistä se oli yleisintä 45–64-vuotiailla ja harvinaisinta alle 16-vuotiailla. Vähintään kahden osajärjestelmän kuntoutukseen osallistuneet olivat keskimäärin vanhempia kuin vain yhden osajärjestelmän kuntoutukseen osallistuneet ja myös naisten osuus oli heillä suurempi.
Rekisteritietoja kuntoutuksesta on hankala koota kattavasti, sillä järjestelmä on hyvin hajanainen ja toimijoita ja rekisterinpitäjiä on lukuisia. Myös kuntoutuksen määrittely aineistoista osoittautui vaikeaksi. Yhtenäiset tietojärjestelmät kuntoutuksesta palvelisivat paitsi tutkijoita, myös kuntoutujia.
Abstract
Prevalence and overlap of participation in rehabilitation in different subsystems – a register-based study among residents of the city of Oulu, Finland, in 2018
Knowledge of the whole spectrum of rehabilitation and of the use of different rehabilitation services by the same individuals is quite fragmented and incomplete. The aim of this study is to examine the prevalence and overlap of participation in rehabilitation in different subsystems among residents of the city of Oulu, Finland, in 2018 using extensive register-based data (N=192,844). The study examines rehabilitation organized by the public social and health care system, by the Social Insurance Institution of Finland, by the earnings-related pension system, as well as physiotherapy in occupational health care and private physiotherapy reimbursed by the Social Insurance Institution of Finland.
In 2018, 18 per cent of the residents of Oulu received rehabilitation of at least one of the examined subsystems (N=34,061). Receiving rehabilitation of public social and health care was the most common; the rarest was rehabilitation within the earnings-related pension system. Women participated in rehabilitation more often than men. Using rehabilitation services was most common in men aged 65 and over, and in women aged 45–64. It was least common in men aged 16–24 years and in women under 16 years of age. The majority (90%) of those who participated in rehabilitation had participated in rehabilitation of only one subsystem. Participation in rehabilitation of several subsystems was more common in women than in men. It was most common in those aged 45–64 years and least common in those under 16 years of age. Those who received rehabilitation of at least two subsystems were, on average, older than those who received rehabilitation of only one subsystem, and more often women.
It is difficult to compile comprehensive register data on rehabilitation, as the system is very fragmented and there are many organizers and registrars. Defining rehabilitation from the data also proved difficult. Unified information systems on rehabilitation would serve not only researchers but also rehabilitees.
Keywords: rehabilitation, register-based research, Finland
29
Ipsen, Catherine, and Grant Swicegood. "Rural and Urban Differences in Vocational Rehabilitation Case Mix, Delivery Practices, and Employment Outcomes." Rehabilitation Research, Policy, and Education 29, no. 4 (2015): 349–70. http://dx.doi.org/10.1891/2168-6653.29.4.349.
Full textAbstract:
Purpose: To examine rural and urban differences in Vocational Rehabilitation (VR) case mix, delivery practices, and employment outcomes.Methods: Rehabilitation Services Administration 911 (RSA-911) case data do not include location indicators that allow for rural analyses. We compiled RSA-911 data with county and ZIP code information from 47 VR agencies matched with additional sources to control for geographic and economic variations. Rural analyses included cross tabulations and logistic regression.Results: Findings indicate that urban, large rural, small rural, and isolated rural outcomes and case mixes are significantly different based on education, age, minority status, receipt of Social Security Disability Insurance and Supplemental Security Income, and disability type (p ≤ .001).Conclusion: Geographic indicators allow for differences to be explored and considered when making programmatic changes within the VR system.
30
Chen, Ying-Chu, Tai-Li Chen, Chia-Chun Cheng, Yu-Cih Yang, Jen-Hung Wang, Hei-Tung Yip, Chung-Yi Hsu, and Hung-Yu Cheng. "High-Intensity Post-Stroke Rehabilitation Is Associated with Lower Risk of Pressure Ulcer Development in Patients with Stroke: Real-World Evidence from a Nationwide, Population-Based Cohort Study." Medicina 58, no. 3 (March 8, 2022): 402. http://dx.doi.org/10.3390/medicina58030402.
Full textAbstract:
Background and Objectives: Multiple factors are associated with pressure ulcer (PU) development, including limited mobility following stroke. We performed a nationwide cohort study to investigate the impact of rehabilitation intensity on the incidence of post-stroke PU. Materials and Methods: Data of patients diagnosed with stroke between 2000 and 2012 were collected from the 2000 Longitudinal Health Insurance Database (Taiwan). Based on the number of rehabilitation sessions attended within 90 days of discharge, the rehabilitation intensity was classified as low, medium, or high. After adjusting for sociodemographic factors and comorbidities, the Cox proportional hazards model evaluated the risk of PU development during the 12-year follow-up period. Kaplan–Meier curves were used to estimate the cumulative incidence of PUs. Results: Our study included 18,971 patients who had their first episode of stroke. Of these, 9829 (51.8%) underwent rehabilitation therapy after discharge. Female patients and patients with a National Institutes of Health Stroke Scale (NIHSS) score >13 points, who commenced high-intensity post-stroke rehabilitation after discharge had a significantly lower risk of PU development than those who underwent low-intensity post-stroke rehabilitation after discharge. Cumulative survival analysis showed a significantly lower cumulative incidence of PU during the 12-year follow-up period in the high-intensity rehabilitation group. Conclusion: Compared with low-intensity post-stroke rehabilitation, high-intensity post-stroke rehabilitation after discharge from hospital is associated with a lower risk of post-stroke PU development, especially in female stroke patients and patients with a NIHSS score >13 points. High-intensity rehabilitation is also associated with a significantly lower cumulative incidence of PU events during the 12-year follow-up period.
31
Eom, Gayeong, Seonjae Been, and Haewon Byeon. "ICF-Based Job Performance Predictors for South Korean Industrial Accident Workers: Population-Based 3-Year Longitudinal Analysis." International Journal of Environmental Research and Public Health 19, no. 13 (June 25, 2022): 7822. http://dx.doi.org/10.3390/ijerph19137822.
Full textAbstract:
Since workers who have experienced industrial accidents may have a physical impairment, their workload is very likely to be less than before the industrial accident. This epidemiological study identified ICF-based predictive factors affecting the work performance of South Korean workers who were economically active after undergoing medical treatment (rehabilitation) related to injuries caused by industrial accidents by using the Panel Study of Worker’s Compensation Insurance (2018–2020) as a reference. We analyzed 1383 subjects who were engaged in economic activities. The explanatory variables included participation factors, activity factors, personal factors, physical function factors, and rehabilitation service factors. The outcome variables were defined by subjective evaluations of current job performance (0 and 10 points). This study analyzed the trajectory of change in work performance and change function predictors over time by using latent growth modeling (LGM). This study found mental activity, indoor activity, occupational activity, disability grade, socioeconomic status, the length of recuperation, self-esteem, and self-efficacy as significant predictors. The results of this study suggested that it would be necessary to prepare a systematic program that considers activity factors to support the independent daily life activities and social participation of workers injured by industrial accidents.
32
Otth, Maria, Sibylle Denzler, Sibylle Schmid, Birgitta Setz, and Katrin Scheinemann. "Perception of Inpatient Oncologic Rehabilitation in Children, Adolescents and Young Adults Diagnosed with Cancer in Switzerland." Klinische Pädiatrie 232, no. 06 (September 2, 2020): 294–99. http://dx.doi.org/10.1055/a-1210-2599.
Full textAbstract:
Abstract Background Inpatient rehabilitation improves physical and psychosocial performance in childhood cancer patients and their families. Two kinds of inpatient rehabilitation are available in specialized institutions in Germany: family-oriented rehabilitation or peer group-oriented rehabilitation for adolescents and young adults (AYA). Our study aimed to find out what Swiss childhood and AYA cancer patients and their families thought about the rehabilitation programs in which they had participated. Patients and methods We conducted a questionnaire-based, cross-sectional study of Swiss childhood and AYA cancer patients and their families whose inpatient rehabilitation stays were scheduled to take place in Germany between May 2012 and March 2019. We analyzed the data descriptively and present our findings in accordance with the STROBE statement. Results Of the 57 eligible families contacted, 38 (67%) responded. Most rated the rehabilitation stay as very good (68%) or good (26%). Nearly all participants emphasized that these programs should be available to all affected patients and their families. Most (80%) thought the program gave them enough valuable information to enable them to cope with daily life after the stay ended. Only one fifth (19%) of the rehabilitation stays were fully funded by the health or disability insurance. Conclusion Participants expressed an overwhelmingly positive opinion about the rehabilitation programs they attended. We are convinced that childhood and AYA cancer patients and their families in Switzerland benefit from these programs and encourage insurances to cover the costs.
33
Pezzopane, Laura, Anthea Gray, Alfredo C. Cordova, Katherine Bergus, and Nicole O. Bernal. "773 Insurance Coverage Does Not Increase Risk of Depression and Anxiety in Burn Patients." Journal of Burn Care & Research 43, Supplement_1 (March 23, 2022): S193—S194. http://dx.doi.org/10.1093/jbcr/irac012.326.
Full textAbstract:
Abstract Introduction A burn injury can have long-term mental and physical effects on individual patients. When burn injuries occur at work, there is an additional unfamiliar stress of income loss and dependence on a third-party payer. Patients with claims through the Bureau of Worker’s Compensation (BWC) report frustration and overall dissatisfaction in working with the BWC to achieve claim coverage. Of workers who are off of work more than 5 days due to a work-related injury, 10% are diagnosed with depression in the 12 months following the injury (Carnide, 2016). In our clinic, screening for depression and anxiety is done through the Patient Health Questionnaire (PHQ-4), a valid four-item assessment tool that utilizes a Likert style measurement to assess symptoms of depression and anxiety (Kroenke et al., 2009). This is a health questionnaire that determines a patient’s risk for depression and anxiety as mild, moderate, or severe. Objective To determine if there is a correlation between insurance type and PHQ-4 scores in burn patients. We hypothesized that risk of depression and anxiety could differ based on payer, which can affect a patient’s access to care, referral approval, and financial burden of treatment. Additional focus was placed on BWC patients due to their reported frustrations and dissatisfaction in working with BWC and the established correlation between depression and missed work. Methods A quality improvement project was initiated based on increased rates of referrals for psychological evaluation and treatment in BWC patients. A retrospective review was conducted of outpatient burn clinic visits where a PHQ-4 questionnaire was completed in the past 3 fiscal years: 7/1/2019-6/30/2021. Results Total of 1932 visits with PHQ-4 collection were reviewed within the above specified time frame. The rates of moderate and high-risk scores for anxiety and depression were highest with BWC and Medicaid patients. Patients with private insurance showed a lower risk of moderate and severe depression. However, there was no significant difference when comparing BWC verses all other insurance. Table 1 Conclusions Overall there was no significant difference in risk of anxiety and depression with BWC versus other insurance coverage based on PHQ-4 scores. Limitations of the study include no distinction of extent of burn injury/burn depth, burn care/treatments, length of hospital stay if any; no distinction was made amongst BWC patients and their length of time off of work. A portion of the timeframe reviewed was during the COVID-19 pandemic.
34
Ito, Toshikazu, Issei Kameda, Naoki Fujimoto, and Ryo Momosaki. "Regional disparities in cardiac rehabilitation volume throughout Japan based on open data from a National Database of Health Insurance Claims." Journal of Rural Medicine 17, no. 4 (2022): 221–27. http://dx.doi.org/10.2185/jrm.2022-015.
Full text
35
Kiani, Mohammad Mehdi, Khatere Khanjankhani, Afsaneh Takbiri, and Amirhossein Takian. "Refugees and Sustainable Health Development in Iran." Archives of Iranian Medicine 24, no. 1 (January 1, 2021): 27–34. http://dx.doi.org/10.34172/aim.2021.05.
Full textAbstract:
Background: Refugees’ access to quality healthcare services might be compromised, which can in turn hinder universal health coverage (UHC), and achieving Sustainable Development Goal (SDG), ultimately. Objective: This article aims to illustrate the status of refugees’ access to healthcare and main initiatives to improve their health status in Iran. Methods: This is a mixed-method study with two consecutive phases: qualitative and quantitative. In the qualitative phase, through a review of documents and semi-structured interviews with 40 purposively-selected healthcare providers, the right of refugees to access healthcare services in the Iranian health system was examined. In the quantitative phase, data on refugees’ insurance coverage and their utilization from community-based rehabilitation (CBR) projects were collected and analyzed. Results: There are international and upstream policies, laws and practical projects that support refugees’ health in Iran. Refugees and immigrants have free access to most healthcare services provided in the PHC network in Iran. They can also access curative and rehabilitation services, the costs of which depend on their health insurance status. In 2015, the government allowed the inclusion of all registered refugees in the Universal Public Health Insurance (UPHI) scheme. Moreover, the mean number of disabled refugees using CBR services was 786 (±389.7). The mean number of refugees covered by the UPHI scheme was 112,000 (±30404.9). Conclusion: The United Nations’ SDGs ask to strive for peace and reducing inequity. Along its pathway towards UHC, despite limited resources received from the international society, the government of Iran has taken some fundamental steps to serve refugees similar to citizens of Iran. Although the initiative looks promising, more is still required to bring NGOs on board and fulfill the vision of leaving no one behind.
36
Brünger, Martin, Sebastian Bernert, and Karla Spyra. "Occupation as a Proxy for Job Exposures? Routine Data Analysis Using the Example of Rehabilitation." Das Gesundheitswesen 82, S 01 (October 28, 2019): S41—S51. http://dx.doi.org/10.1055/a-0965-6777.
Full textAbstract:
Abstract Aim of the study Job exposures are associated with health-related outcomes including sick leave and reduction in earning capacity. Rehabilitation of persons in working age aims primarily to secure or restore work capacity. Information concerning job exposures is, however, not directly available in routine data of healthcare payers. Since exposures relate to specific occupations and the current occupation is part of routine data, job exposures may be determined indirectly via job-exposure matrices (JEM). The aim of the study is to describe the possibilities and challenges of the representation of job exposures by the occupation according to routine data using the example of rehabilitation. Methods The Scientific Use File ‘SUFRSDLV15B’ of the German Pension Insurance was analysed. We used data from n=1 242 171 persons in work with at least one completed medical rehabilitation between 2008 and 2015 (dataset 1). The occupation is coded according to KldB 88 or KldB 2010 (German Classification of Occupations). In addition, data from a nationwide survey with 2530 rehabilitation patients was available (dataset 2). Job exposures are operationalized by the Job Exposure Index via JEM. The relationship to the return-to-work prognosis at the end of rehabilitation (dataset 1) and to patient reported outcome measures (dataset 2) is described. Results Information concerning the occupation is available for about 91% of rehabilitation measures of employed patients for the year prior to rehabilitation. At high levels of job exposures, the proportion of persons with a predicted working capacity in the last job of fewer than 3 h per day increased by a factor of 4 compared to low-level job exposures (23.5 vs. 6.1%). On the other hand, there is a low association only to reduced working capacity in the general labour market (2.9 vs. 2.4%). High-level job exposures are associated with self-reported, work-related impairments. Conclusion The Job Exposure Index may offer a valid approach to depict occupation-related exposures. The index can be used in the analysis of routine data of the pension insurance and other social security funds, as well as in the linkage of individual assessment data with routine data containing the occupation, without any additional data collection effort. Due to its construction based on job classifications, it will not replace the assessment of individual burdens.
37
Asa, Gregorius Abanit, Nelsensius Klau Fauk, Lillian Mwanri, and Paul Russell Ward. "Understanding Barriers to the Access to Healthcare and Rehabilitation Services: A Qualitative Study with Mothers or Female Caregivers of Children with a Disability in Indonesia." International Journal of Environmental Research and Public Health 18, no. 21 (November 3, 2021): 11546. http://dx.doi.org/10.3390/ijerph182111546.
Full textAbstract:
Accessibility to healthcare and rehabilitation services for children with a disability (CWD) is essential to improving their health and wellbeing. However, access to the services, especially in many settings in developing countries with scarcity of resources, is still limited. As part of a qualitative study exploring impacts of caring for CWD on mothers or female caregivers and their coping strategies, this paper describes barriers for access to healthcare and rehabilitation services for CWD in Belu district, Indonesia. One-on-one, in-depth interviews were conducted with 22 mothers or female caregivers of CWD. Participants were recruited using a combination of purposive and snowball sampling techniques. These were supplemented with interviews with two staff of disability rehabilitation centers in Belu to understand any additional barriers. Data analysis was guided by a qualitative data analysis framework. Our analysis identified that lack of affordability of healthcare services (high costs and low financial capacity of mothers) was the key barrier for access to healthcare and rehabilitation services CWD. Religious or faith-based factors, such as being a non-Catholic (Belu is predominantly Catholic), converting from Catholic to other religions, and the belief in children’s disability condition as “God’s will”, were also influencing factors for lack of access to the services. Shortage of staff, distrust in the therapy skills of staff at rehabilitation centers, and unavailability of appropriately trained healthcare professionals were structural or system-related barriers. The findings indicate the need for government-owned and run disability rehabilitation centers (not faith-based), the provision of fully subsidised health insurance to provide free services, and the provision of qualified therapists and healthcare professionals (to build trust) in Belu and other similar settings in Indonesia.
38
Götz, Simon, Morten Wahrendorf, Johannes Siegrist, and Nico Dragano. "Social inequalities in medical rehabilitation outcomes—a registry-based study on 219 584 insured persons in Germany." European Journal of Public Health 30, no. 3 (March 10, 2020): 421–26. http://dx.doi.org/10.1093/eurpub/ckaa024.
Full textAbstract:
Abstract Background Given limited knowledge on the extent of social inequalities in longer-term work ability of people with a chronic disease, this study analyzes social inequalities of three consecutive indicators of work ability following medical rehabilitation in a large sample of insured employees. Methods Based on data from the German statutory pension insurance, a representative 20% random sample of all employed persons undergoing medical rehabilitation between 2006 and 2008 was included in a longitudinal analysis (n=219 584 persons). Three measures of consecutive work-related outcomes (physicians’ assessment of work ability at discharge; return to work in the year thereafter; disability pension during follow-up) and socioeconomic position (SEP) (education, occupational position and income) were assessed. Adjusted relative risks (RRs) for each outcome were calculated according to SEP, applying Poisson regression analysis. Results The measures of SEP were associated with all three outcomes of work ability in the fully adjusted models. Relatively strongest relationships were observed for education as SEP measure, and they were particularly pronounced for ‘low work ability’ (RR=2.38 for lower secondary education compared to tertiary education; 95% CI: 2.26–2.51). Based on average marginal effects, absolute differences of work ability by SEP indicate a socially graded pattern, with only few exceptions. Conclusions Despite Germany’s universal access to medical and vocational rehabilitation social inequalities in longer-term work ability following chronic disease persist, thus calling for targeted programmes of prevention and occupational health promotion.
39
Park, Myung Soo, Sunki Lee, Taehoon Ahn, Doyoung Kim, Mi-Hyang Jung, Jae Hyuk Choi, Seongwoo Han, Kyu Hyung Ryu, and Eung Ju Kim. "Current status of cardiac rehabilitation among representative hospitals treating acute myocardial infarction in South Korea." PLOS ONE 16, no. 12 (December 8, 2021): e0261072. http://dx.doi.org/10.1371/journal.pone.0261072.
Full textAbstract:
Cardiac rehabilitation services are mostly underutilized despite the documentation of substantial morbidity and mortality benefits of cardiac rehabilitation post-acute myocardial infarction. To assess the implementation rate and barriers to cardiac rehabilitation in hospitals dealing with acute myocardial infarction in South Korea, between May and July 2016, questionnaires were emailed to cardiology directors of 93 hospitals in South Korea; all hospitals were certified institutes for coronary interventions. The questionnaires included 16 questions on the hospital type, cardiology practice, and implementation of cardiac rehabilitation. The obtained data were categorized into two groups based on the type of the hospital (secondary or tertiary) and statistically analysed. Of the 72 hospitals that responded (response rate of 77%), 39 (54%) were tertiary medical centers and 33 (46%) were secondary medical centers. All hospitals treated acute myocardial infarction patients and performed emergency percutaneous coronary intervention; 79% (57/72) of the hospitals performed coronary artery bypass grafting. However, the rate of implementation of cardiac rehabilitation was low overall (28%, 20/72 hospitals) and even lower in secondary medical centers (12%, 4/33 hospitals) than in tertiary centers (41%, 16/39 hospitals, p = 0.002). The major barriers to cardiac rehabilitation included the lack of staff (59%) and lack of space (33%). In contrast to the wide availability of acute-phase invasive treatment for AMI, the overall implementation of cardiac rehabilitation is extremely poor in South Korea. Considering the established benefits of cardiac rehabilitation in patients with acute myocardial infarction, more administrative support, such as increasing the fee for cardiac rehabilitation services by an appropriate level of health insurance coverage should be warranted.
40
Conroy, Susan S., Min Zhan, William J. Culpepper, Walter Royal, and Mitchell T. Wallin. "Self-directed exercise in multiple sclerosis: Evaluation of a home automated tele-management system." Journal of Telemedicine and Telecare 24, no. 6 (April 25, 2017): 410–19. http://dx.doi.org/10.1177/1357633x17702757.
Full textAbstract:
Introduction Physical rehabilitation is one of the few non-pharmaceutical therapies for maintaining or improving walking ability for patients with multiple sclerosis. However, travel distance to rehabilitation clinics, neurological disability and insurance coverage often limit access to specialised rehabilitation services. To address these issues, we utilised a web-based system to support a home-based self-directed exercise programme. Methods Patients ( n = 24) were randomised to either routine home rehabilitation or to the multiple sclerosis home automated tele-management system for a six-month period. The study group had a mean age of 50.4 years, 56% of patients were male, and 67% had progressive multiple sclerosis with an overall mean Patient Determined Disease Steps score of 4.4 (cane or crutch required for walking). Key outcomes included the timed 25-foot-walk, six-minute-walk and the Berg Balance Scale. Results There was no statistically significant difference in the change of the primary walking outcome measure, timed 25-foot-walk, at six months between the home automated tele-management intervention and control groups ( p = 0.44). Similarly, change scores for the six-minute-walk were not significantly different between the home automated tele-management or control groups at six months. Discussion Maintaining overall gait abilities in this group of predominantly progressive multiple sclerosis patients is notable. Exercise adherence was positively associated with higher multiple sclerosis disability and self-reported walking ability. Study engagement and participation in routine home-based exercise for the entire study period was challenging. Further research using clinical video telerehabilitation techniques that optimise patient involvement warrants further study.
41
Lin, Jin-Ding, Yi-Hsin Chen, and Lan-Ping Lin. "Outpatient rehabilitation utilization and medical expenses in children aged 0–7years with ADHD: Analyses of population-based national health insurance data." Research in Developmental Disabilities 34, no. 7 (July 2013): 2127–32. http://dx.doi.org/10.1016/j.ridd.2013.03.034.
Full text
42
Highsmith, M. Jason, Jason T. Kahle, Molly Knight, Ayla Olk-Szost, Melinda Boyd, and Rebecca M. Miro. "Delivery of cosmetic covers to persons with transtibial and transfemoral amputations in an outpatient prosthetic practice." Prosthetics and Orthotics International 40, no. 3 (January 9, 2015): 343–49. http://dx.doi.org/10.1177/0309364614564024.
Full textAbstract:
Background:Limb loss negatively impacts body image to the extent that functional activity and societal participation are affected. Scientific literature is lacking on the subject of cosmetic covering for prostheses and the rate of cosmetic cover utilization by cover type, gender, amputation level, and type of healthcare reimbursement.Objectives:To describe the delivery of cosmetic covers in lower limb prostheses in a sample of people with lower extremity amputation.Study design:Cross-sectional designMethods:Patient records from an outpatient practice were reviewed for people who received a transtibial or transfemoral prosthesis within a selected 2-year period.Results:A total of 294 records were reviewed. Regardless of the amputation level, females were significantly ( p ≤ 0.05) more likely to receive a cover. Type of insurance did not affect whether or not a cover was used, but Medicare reimbursed more pull-up skin covers.Conclusion:There were differences regarding cosmetic cover delivery based on gender, and Medicare reimbursed for more pull-up skin covers at the transtibial level than other reimbursors did. This analysis was conducted in a warm, tropical geographic region of the United States. Results may differ in other parts of the world based on many factors including climate and local views of body image and disability.Clinical relevanceCosmetic covering rates are clinically relevant because they provide insight into which gender is utilizing more cosmetic covers. Furthermore, it can be determined which type of covers are being utilized with greater frequency and which insurance type is providing more coverage for them.
43
Swartz, Maria Chang, Donna M. Kelly, Keri L. Schadler, Clark R. Andersen, Stephanie J. Wells, Shiming Zhang, Alakh Rajan, Amy Heaton, and Karen Moody. "System-level barriers and facilitators to cancer rehabilitation delivery for children with cancer." Journal of Clinical Oncology 40, no. 28_suppl (October 1, 2022): 81. http://dx.doi.org/10.1200/jco.2022.40.28_suppl.081.
Full textAbstract:
81 Background: Up to 20% of childhood cancer survivors suffer from a significant physical function impairment due to cancer or cancer treatment. Early intervention with Occupational Therapy (OT) and Physical Therapy (PT) increases engagement in personal care, leisure interests, school-based tasks, return to work, and prevents cognitive decline. Despite this, less than 30% of childhood cancer survivors receive PT services. To date, facilitators and barriers to implementing cancer rehabilitation (CR) for pediatric cancer survivors have not been adequately explored. Thus, the aim of this research was to identify system-level barriers and facilitators to CR delivery based on surveys completed by hospital administrators, oncology physicians, advanced practice providers, and OT/PT therapists. Methods: A cross-sectional method was employed. Three previously published cardiac rehabilitation delivery instruments specific for administrators, OT/PT therapists and clinical providers respectively were adapted to evaluate CR delivery. All surveys used a 5-point Likert-type response format (e.g., 1 = strongly disagree to 5 = strongly agree). Surveys ranged from 12 items (therapist survey) to 23 items (administrator survey). Questions pertained to knowledge, attitudes, and perceptions regarding CR. Results: A total of 20 administrators (mean age, 49.95 years old, 65% non-Hispanic White, 65% female), 20 providers (mean age, 43.4 years old, 71.4% non-Hispanic White, 67% female), and 20 therapists (mean age, 38.3 years old, 70% non-Hispanic white, 84% female) completed surveys. Administrators’ results indicated mid-range CR knowledge (median: 3.5; IQR 2,5), and all perceived CR as important or extremely important to outpatient care (median: 5; IQR 4,5). Limited insurance coverage and lack of space were the top barriers identified by administrators. Eighty percent of providers endorsed that clinical practice guidelines promote CR referral (median 4; IQR 4,5) and none reported being skeptical of CR benefits. Provider-identified barriers included an inconvenient referral process, lack of CR patient-education materials, and inadequate information on external CR resources. Therapists identified rate of absenteeism and referral rates as barriers to CR. Ninety percent of therapists reported hybrid CR delivery (supervised and unsupervised exercise) could facilitate CR participation (median 4; IQR 4,4). Conclusions: System-wide, there was adequate knowledge and positive perceptions and attitudes regarding CR. However, we identified multiple barriers presenting opportunities for multilevel interventions. These included: insurance coverage advocacy, streamlining referral processes to CR services, providing information on external CR programs, providing patient education materials, and leveraging hybrid CR delivery to optimize participation.
44
Protas, Nina. "Institute of Rehabilitation of Credit Institutions in Russia: Problems and Prospects of Development." Ideas and Ideals 14, no. 1-2 (March 25, 2022): 261–77. http://dx.doi.org/10.17212/2075-0862-2022-14.1.2-261-277.
Full textAbstract:
The article is devoted to the study of the institution of rehabilitation of credit institutions in Russia, its current problems and prospects for further development. The author examines the influence of the institution of reorganization on the stability of the country’s banking system. The object of research in the article is the Institute of Reorganization of Credit Institutions in Russia. The subject of the study is an assessment of the current state of the domestic institute of rehabilitation of credit institutions. The theoretical and methodological basis of this article is the normative legal acts of the Russian Federation, the normative acts of the Bank of Russia, scientific publications and studies of Russian scientists devoted to the study of this issue. Statistical materials of the Federal State Statistics Service, the Bank of Russia, as well as other information materials posted on the Internet were used as an information base. The study is based on methods of statistical analysis, a review of literature, regulations and other information sources concerning the rehabilitation of credit institutions, and covers 1990-2021. The definition of rehabilitation of credit institutions is formulated. The main stages of the development of the institution of rehabilitation of credit institutions are considered: the mechanism of the rehabilitation procedure, the main changes in it at each stage of the institute’s development, its advantages and disadvantages. The ‘credit’ mechanism of bank rehabilitation with the participation of the Deposit Insurance Agency (DIA) and the mechanism with the participation of the Management Company of the Banking Sector Consolidation Fund specially established by the Bank of Russia (LLC “CC FCBS”) are considered in the most detail. Each of these mechanisms has its advantages and disadvantages highlighted. Currently, both of these methods are used in Russia. Based on the analysis of the current state of the institute of rehabilitation and the effectiveness of the rehabilitation of credit institutions, a number of problems are identified: the lack of a single regulatory act regulating the activities of this institute, the high cost of the procedures of rehabilitation, etc. Recommendations for their solution and improvement of the institution of rehabilitation of credit institutions in Russia are given for each identified problem.
45
Rickert, Dale LL, Margaret S. Barrett, and Bronwen J. Ackermann. "Injury and the Orchestral Environment: Part III. The Role of Psychosocial Factors in the Experience of Musicians Undertaking Rehabilitation." Medical Problems of Performing Artists 29, no. 3 (September 1, 2014): 125–35. http://dx.doi.org/10.21091/mppa.2014.3028.
Full textAbstract:
Workplace rehabilitation in the orchestral setting poses a number of challenges that arise in part due to a poor fit between generic injury insurance and medical care and the elite performance requirements of professional musicians. Currently, the orchestral profession lacks information and strategies to best deal with the unique challenges of this complex rehabilitation environment. In order to inform future directions for research and suggest possible changes of practice, the researchers conducted a qualitative case-study aimed at understanding the injury and rehabilitation experiences of professional musicians. In-depth semi-structured interviews were undertaken with three chronically injured professional cellists from a single Australian orchestra. After initial data analysis, further interviews were undertaken with a set of five orchestral management staff as a means of data triangulation. All data were analysed using a themes-based analysis-of-narrative approach. The findings indicate that injury concealment played a considerable role in the development of chronic injuries for these musicians, and management staff felt that this concealment may be the norm amongst orchestral musicians. The musicians in this study suffered emotional and psychological trauma as the result of their injuries, and two participants felt socially marginalised. During rehabilitation, the musicians in this study encountered difficulties with medical staff not understanding the elite performance requirements of orchestral work. The article proposes recommendations that may assist in dealing with the complex challenges of injury rehabilitation in the orchestral environment.
46
Liukko, Jyri. "Työeläkekuntoutuksen vaikuttavuuden kehittäminen ja työkykyajattelu." Kuntoutus 44, no. 4 (December 17, 2021): 18–30. http://dx.doi.org/10.37451/kuntoutus.112850.
Full textAbstract:
Artikkelissa tarkastellaan työeläkelaitosten rahoittaman ammatillisen kuntoutuksen eli työeläkekuntoutuksen toimivuutta ja kehittämistä työeläkelaitosten asiantuntijoiden haastatteluiden perusteella. Viimeaikaiset tutkimustulokset työeläkekuntoutuksen vaikuttavuudesta ovat herättäneet keskustelua erityisesti työpaikalla tapahtuvien lyhytaikaisten toimien kustannustehokkuudesta. Tätä taustaa vasten artikkelin painopiste on asiantuntijoiden esiin nostamissa kehittämisajatuksissa. Aineisto muodostuu työeläkelaitosten kuntoutusasiantuntijoiden ja vakuutuslääkärien haastatteluista. Aineisto sisältää kuusi laajaa haastattelua, joissa oli yhteensä 15 haastateltavaa. Menetelmänä käytetään temaattista sisällönanalyysia. Tutkimuksen teoreettinen viitekehys muodostuu erilaisista työkyvyn edistämisen malleista.
Keskeisenä kehittämisen kohteena haastatteluissa pidettiin ensinnäkin panostamista työn muokkaamiseen työkokeilujen aikana ja erilaisiin jatkotoimenpiteisiin niiden jälkeen. Toiseksi työkokeiluja pidempiaikaisemmat kuntoutustoimenpiteet,kuten työhönvalmennus ja koulutus, nähtiin usein järkeviksi vaihtoehdoiksi kestävien työllisyysvaikutusten näkökulmasta. Kolmanneksi kuntoutuksen työllisyysvaikutuksia saattaisi haastattelujen perusteella parantaa erityisesti työeläkejärjestelmän, Kelan ja työvoimapalvelujen yhteistyön tiivistäminen. Artikkeli osoittaa, minkälaisiin työkyvyn edistämisen malleihin haastateltavien esittämät kehittämisideat kytkeytyvät.
Abstract
Improving the effectiveness of vocational rehabilitation under the earnings-related pension scheme and the concept of work ability. Study based on interviews with experts from earnings-related pension providersIn this interview-based article we examine the effectiveness of vocational rehabilitation financed by earnings-related pension providers and its development. Recent studies on the efficiency of vocational rehabilitation have raised discussions particularly on the cost-efficiency of short-term rehabilitation at the workplace. The focal area of this article is thus on the development ideas presented by the experts. The data is based on interviews with rehabilitation experts at earnings-related pension providers and insurance physicians. The dataset consists of six extensive interviews with a total of 15 interviewees. The data is analysed using thematic content analysis. The theoretical framework of the study consists of various models of work ability.
As key areas that require improvement the interviewees pointed out adjusting work tasks during work try-outs and taking various further actions after completing work try-outs. Second, longer-lasting rehabilitation measures, such as job coaching and training, were increasingly seen as viable options to achieve sustainable employment effects. Thirdly, based on the interviews, the employment effects of vocational rehabilitation may be improved through, in particular, closer co-operation between the earnings-related pension system, Kela and employment services. The article shows which types of models of work ability the development ideas of the experts are connected to.
Key words: vocational rehabilitation, work ability, effectiveness, co-operation, experts, interview study
47
Carnero Contentti, Edgar, Susana Giachello, and Jorge Correale. "Barriers to access and utilization of multiple sclerosis care services in a large cohort of Latin American patients." Multiple Sclerosis Journal 27, no. 1 (January 21, 2020): 117–29. http://dx.doi.org/10.1177/1352458519898590.
Full textAbstract:
Background: Multiple sclerosis (MS), is an emergent disease in Latin America (LATAM), which raises substantial socioeconomic challenges to a region where most countries remain as economies in development. Objective: To assess barriers to access and utilization of MS care services in a regional cohort survey. Methods: We conducted a cross-sectional study based on a self-reported survey. Patients with MS (PwMS) completed this regional survey in 12 Latin American (LATAM) countries. PwMS were also divided into those with healthcare insurance (including certain local national social security programs) and those without healthcare insurance (treated at public institutions). Results: We surveyed 1469 PwMS and identified significant regional differences in relation to access to complementary tests, rehabilitation services, and prescription of disease-modifying therapies (DMTs). Between 44.4% and 73.5% of PwMS were unemployed and nearly 50% had completed higher education. PwMS receiving care from the private sector reported greater access to imaging, DMTs, and fewer problems obtaining DMTs compared to those treated at public institutions. Multivariate analysis showed that lack of private insurance (OR = 2.21, p < 0.001), longer MS duration (OR = 1.02, p = 0.001), lower level of education (OR = 0.66, p = 0.009), and unemployment (OR = 0.73, p = 0.03) were independently associated with inappropriate delivery of DMTs. Conclusion: These findings suggest barriers to access and utilization of MS care services across LATAM are prevalent. We identified several factors predicting unmet healthcare needs in PwMS.
48
Gagin, Roni, Neta HaGani, Itay Levy, and Doron Norman. "There Is No Place Like Home: A Survey on Satisfaction and Reported Outcomes of a Home-Based Rehabilitation Program Among Orthopedic Surgery Patients." Journal of Patient Experience 7, no. 6 (December 5, 2019): 1715–23. http://dx.doi.org/10.1177/2374373519892764.
Full textAbstract:
Background: Home-based rehabilitation (HBR) was previously found to be associated with positive outcomes that are equal to inpatient rehabilitation. Few studies have examined the challenges patients are facing during rehabilitation and recovery and their satisfaction from HBR. Objective: The purpose of this study was to examine the overall satisfaction and reported outcomes of HBR. Methods: A telephone survey was conducted among 146 orthopedic surgery patients who participated in an HBR program, at the end of the HBR and 6 months after. The questionnaire included information about level of independence, satisfaction from HBR, and difficulties during HBR. Findings: The overall satisfaction was high (73.1%). Patients reported on improvements in level of independence between the time of hospital discharge, the end of the program ( P = .0001), and the 6 months follow-up ( P = .004). Long wait for beginning of HBR, being a widower, and residing in a facility or with a nonfamilial caregiver were associated significantly with less general well-being and independence. The repeated measures analysis showed age lower than 71 and private health insurance ownership were associated with a better recovery. The most common difficulties reported were physical difficulties, lack of function, and caregivers’ burden. Conclusions: Patients and families need more emotional, social, and physical support during HBR. The increase in health services delivered in community settings requires a more clear-cut policy and supervision for HBR and the follow-up services.
49
Chuang, Ching-Hui, Po-Cheng Chen, Chyi-Huey Bai, Yi-Lin Wu, Ming-Chao Tsai, and Chieh-Yu Li. "Association between Spinal Cord Injury and Alcohol Dependence: A Population-Based Retrospective Cohort Study." Journal of Personalized Medicine 12, no. 3 (March 16, 2022): 473. http://dx.doi.org/10.3390/jpm12030473.
Full textAbstract:
Spinal cord injury (SCI) is a devastating disorder. Alcohol abuse has been recognized as hindering SCI patients from rehabilitation, thus leading to longer length of days and poorer prognosis. This article aimed to investigate the association between spinal cord injury (SCI) and alcohol dependence. Data were derived from the National Health Insurance Research Database (NHIRD). The incidence of alcohol dependence between SCI and non-SCI groups was compared. Other possible risk factors were also analyzed. Patients (N = 5670) with SCI from 2000 to 2009 were initially assessed for eligibility. After propensity score matching, 5639 first-time SCI survivors were included. The Cox proportional hazard regression model was used to assess differences in the incidence of alcohol dependence syndrome. Based on the adjusted hazard ratios (HR), the SCI group had a higher hazard for alcohol dependence syndrome compared to the non-SCI group (adjusted HR: 1.39, 95% CI: 1.03~1.86, p = 0.0305). The injury level did not have an impact on the incidence of alcohol dependence syndrome. A higher incidence of alcohol dependence syndrome was related to male patients, lower insurance levels, higher Deyo’s CCI, and psychiatric OPD times. A lower incidence of alcohol dependence syndrome was related to elder age. The incidence of alcohol dependence increased after the occurrence of SCI and was also related to age, sex, monthly income, comorbidities, and psychiatric problems. The injury level did not affect the incidence of alcohol dependence after SCI.
50
Kozenko, Yurii A., and Tat'yana E. Kozenko. "The specificity of interaction of medical servers using the digital ruble." Siberian Financial School, no. 2 (September 8, 2022): 72–76. http://dx.doi.org/10.34020/1993-4386--2022-2-72-76.
Full textAbstract:
Digital means of payment, including the digital ruble proposed for implementation by the Central Bank of the Russian Federation, are able to become an effective element of complex interaction within such areas as healthcare, provision of medicines, rehabilitation, provision of geranthological services, social and pension provision. With the use of digital means of payment, which involve the most severe accounting of any of their movement, really significant prospects open up. To the maximum extent, all possible positive potential should be tried from the very beginning. Based on this logic, not only medical and social insurance funds, but also medical institutions should be initially considered as full-fledged links in the system of using the digital ruble being formed by the Central Bank.