When people think about rehabilitation, they often envision physiotherapy sessions. However, rehab is far more complex than that and requires specialist services.
Rehabilitation is an essential health service that should be available to anyone with a disability or chronic impairment. It improves quality of life, and it also reduces the cost of care.
Cost-Effectiveness
Rehabilitation reduces the impact of a health condition by helping an individual live independently and participate in daily activities. It also helps manage complications of a health condition and improves an individual’s quality of life. For these reasons, it is important for healthcare systems to make rehabilitation interventions available. However, it is also crucial to ensure that the cost of these interventions is reasonable.
In a recent study, Kinoshita et al evaluated the cost-effectiveness of different post-stroke rehabilitation pathways using high-quality individual participant-level data. The authors concluded that 7-days-per-week rehabilitation was a highly cost-effective treatment strategy from the public healthcare payer’s perspective.
This study showed that home-based rehabilitation is likely to be cost-effective in most European countries when compared with centre-based therapy at a societal willingness-to-pay threshold of one times the country GDP per capita. The sensitivity analyses showed that the incremental cost-effectiveness ratios remained dominant when the number of days of rehabilitation per week and the rehabilitation fee were varied.
Treatment Options
The goal of rehabilitation is to help people achieve long-term sobriety and reduce the social, legal, and financial costs of addiction. It includes a variety of treatment options aimed at addressing physical, mental, and spiritual health.
Inpatient rehabilitation programs, also known as residential treatment, are more structured and usually involve living in a substance-free facility on a full-time basis. These programs may offer around-the-clock medical care and therapeutic support. They are typically recommended for people with co-occurring mental health disorders or long histories of drug use.
Outpatient rehab, which is less intensive than inpatient treatment, allows people to live at home or in sober living homes while they attend weekly therapy sessions. Many outpatient rehabilitation programs offer flexible scheduling, so clients can attend sessions on their own schedules. Some outpatient treatment centers offer holistic therapies that integrate mind, body, and spirit. These include yoga, acupuncture, and meditation. Some rehab programs like RehabNear.Me also offer fitness therapy, which helps people regain control of their physical health by encouraging them to exercise regularly to increase the release of feel-good hormones such as dopamine.
Preventing Hospitalizations
Integrating rehabilitation into health care systems maximizes the impact of medical and surgical interventions, reduces risks of ongoing complications that can burden health systems, and provides people with better opportunities to work, play, learn and live more independently. This benefits both the individual and society, with the largest impacts falling on the poorest.
Effective rehabilitation is person-centred, with the treatment process reflecting an individual’s needs and goals. It is delivered in hospitals, primary health centers and communities, and may be provided by a wide range of professionals, depending on an individual’s needs and local availability of rehabilitative services.
Hospital readmissions set patients back in their recovery and increase the overall cost of healthcare. To reduce readmissions, Encompass Health used predictive analytics to identify patients who are at risk for a readmission. They then created an order set in their EMR called Power Plans for these identified conditions—COPD, heart failure and altered mental status (AMS). This allows them to provide additional monitoring and support to prevent hospital readmissions.
Managing Chronic Illnesses
Depending on the etiology of the health condition, rehabilitation can help mitigate the disabling effects of a wide range of chronic illnesses, whether diseases or injuries. It does so by equipping people with self-management strategies to better manage their symptoms, modifying their environment to accommodate their specific needs and supporting them to participate in meaningful activities like working or caring for family members.
It may also include cognitive interventions, such as memory drills or neurocognitive training, to reduce the impact of an illness on mental function. Moreover, it can include the prescription of medication for pain relief or to control other symptoms, such as spasticity or tone, if this is within the scope of practice of the provider.
The essential package of rehabilitation interventions is designed to be delivered across all service delivery platforms and levels of expertise. This includes both community and primary health centers, as well as referral hospital settings. This is done to reflect the global variation in rehabilitation capability, as well as the fact that many of the core rehabilitation interventions can be delivered by non-specialist health workers with limited rehabilitation training.