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A Journal on Physical Medicine and Rehabilitation after Pathological Events

Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Europa Medicophysica 1999 September;35(3):135-42

language: English

National Health District Organisation of ­home-­based reha­bil­i­ta­tion ser­vic­es. Contributions and com­ments

Carta A.

ASL, Province of Varese, Varese (Italy)


The aim of the ­present ­study was to ­address ­issues regard­ing the organ­isa­tion of inte­grat­ed reha­bil­i­ta­tion and ­social ser­vic­es in the ­home-set­ting. Recent leg­is­la­tion clear­ly indi­cates the organ­isa­tion and the ­tasks of the National Health and Social Service Districts. The ­issues ­were ­explored by mak­ing ref­er­ence to the sci­en­tif­ic lit­er­a­ture and by col­lect­ing the ques­tions ­raised by ­patients, ­their fam­i­lies, and the ­staff ­involved in ­their ­care. Five ­main are­as of con­cern ­were iden­ti­fied. Although the cul­tu­ral mod­el of inte­grat­ed ­health and ­social ser­vic­es has ­been ­approved by ­recent leg­is­la­tion, its imple­men­ta­tion ­appears to be ­fraught ­with dif­fi­cul­ties. In our coun­try, it is ­felt ­that inte­grat­ed reha­bil­i­ta­tion ser­vic­es pro­vid­ed in the ­home set­ting ­need to be reor­gan­ised at ter­ri­to­ri­al lev­el. At con­gress­es, atten­tion has ­been ­drawn to the neces­sity of pro­vid­ing on-­going assis­tance in var­i­ous ­health-­care set­tings (hos­pi­tals, ter­ri­to­ry, insti­tutes, ­home-set­ting) ­while safe­guard­ing the prin­ci­ples of effec­tive­ness, effi­cien­cy, qual­ity and eth­ics. All mem­bers of the ­health-­care ­team ­must ­receive prop­er pro­fes­sion­al train­ing in keep­ing ­with European stan­dards and inter­na­tion­al accred­i­ta­tion cri­te­ria. In the reha­bil­i­ta­tion set­ting, ­there is a strong­ly-­felt ­need for ­research on sev­er­al ­aspects of organ­isa­tion, the ade­qua­cy of treat­ments, out­come assess­ment, epi­dem­i­olog­i­cal stud­ies and the cor­rect use of resourc­es, safe­guard­ing the ­patients’ involve­ment and the ­human ­approach to med­i­cal ­care. The solu­tions adopt­ed by the com­mu­nity at ­large as ­well as by the accred­it­ed sci­en­tif­ic com­mu­nity are pre­sent­ed. In the ­case of ­still out­stand­ing prob­lems, sug­ges­tions ­from var­i­ous Authors as ­well as our own con­tri­bu­tions are dis­cussed.

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