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Europa Medicophysica 1999 September;35(3):135-42

Copyright © 1999 EDIZIONI MINERVA MEDICA

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.