Ensuring of rehabilitation care quality provision: organizational-methodological aspect

Authors

  • T.M. Bezverkhniuk SI «Ukrainian Research Institute of Medical Rehabilitation and Resort Therapy of the Ministry of Health of Ukraine», Lermontovsky lane, 6, Odesa, 65014, Ukraine https://orcid.org/0000-0002-2567-8729
  • I.K. Babova SI «South Ukrainian National Pedagogical University named after K.D. Ushynsky», Staroportofrankivska str., 26, Odesa, 65000, Ukraine https://orcid.org/0000-0003-1018-8302

DOI:

https://doi.org/10.26641/2307-0404.2022.4.271230

Keywords:

rehabilitation in health care, standards, quality, recommended rehabilitation program

Abstract

Introduction of international treatment protocols into medical care determines the need for scientific substantiation of the mechanisms of their adaptation in rehabilitation care. On the basis of a systemic approach we substantiated the organizational model of quality assurance for the provision of rehabilitation care in health care system in Ukraine, which consists of four interacting subsystems: management, functional, monitoring (resultative) and supply (process) subsystems. The state of rehabilitation care provision in Ukraine at the expense of the Social Insurance Fund of Ukraine and the National Health Service of Ukraine was analyzed. Need to renovate medical and technological documentation of rehabilitation care for the main groups of socially significant diseases that lead to disability of the population was grounded. Recommended program of rehabilitation at the health-resort stage of patients after coronavirus disease (COVID-19) is proposed for health-resort institutions as a methodical basis for the introduction of updated medical-technological standardization documents, which will contribute to improving the quality of rehabilitation care in Ukraine. Typical (recommended) rehabilitation program consists of general provisions on the organization of rehabilitation care, in particular the existing documentary base; indications, contraindications and criteria for admission to the health-resort stage of rehabilitation (in the post-acute or long-term period); diagnostic plan; regulation of actions in case of deterioration of the patient's clinical condition; approximate duration of the rehabilitation course; tasks of the rehabilitation stage; general characteristics of the resort and available natural healing resources; list of rehabilitation procedures; indicators of the effectiveness of rehabilitation care. The program was implemented in a number of health-resort institutions of Ukraine.

References

[Fundamentals of Ukrainian legislation on health care]. Law of Ukraine of 1992, renovation 2020, Pub. L. No. 2802-ХІІ. (2020). Ukrainian. Available from: https://zakon.rada.gov.ua/laws/show/2801-12#Text

[About rehabilitation in health care sphere]. Law of Ukraine of 2020, Pub. L. No. 103-IX. (Dec 03, 2020). Ukrainian. Available from: https://zakon.rada.gov.ua/laws/show/1053-20#Text

[Methodology for development and implementation of medical standards of medical care based on evidencebased medicine]. Order of the Ministry of Health of Ukraine of 2012, Pub. No. 751. (Sep 28, 2012). Ukrainian. Available from: https://zakon.rada.gov.ua/laws/show/z2001-12#Text

Diachuk D, Zyukov O, Lishchyshyna O. [Rationale of perspective directions of standardization of medical care of the population of Ukraine at the turn of 2020]. Clinichna ta profilactychna medycyna. 2020;3(13):4-11. Ukrainian. doi: https://doi.org/10.31612/2616-4868.3(13).2020.01

Golik V, Syvak O. Assessment of national disability, health and rehabilitation system in Ukraine. Reflec-tions disability and rehabilitation subcluster meeting. Ukraynskyi visnyk mediko-sotsialnoi ekspertyzy. 2016 March 11;1(19):26-62.

International classification of functioning, disability and health: ICF. World Health Organization; 2001.

Situation assessment of rehabilitation in Ukraine. Copenhagen: WHO Regional Office for Europe; 2021.

[About state financial guarantees of medical care for the population]. Law of Ukraine of 2017, Pub. L. No. 2168-VІІІ. (Oct 19, 2017). Ukrainian. Available from: https://zakon.rada.gov.ua/laws/show/2168-19#Text

[On the approval of licensing conditions for conducting business activities in medical practice]. Resolution of the CMU of 2016, Pub. No. 285. (March 02, 2016). Ukrainian. Available from: https://zakon.rada.gov.ua/laws/show/285-2016-%D0%BF#Text

[The procedure for reimbursement of expenses for the provided social services for the treatment of insured persons and their family members after diseases and injuries in the rehabilitation departments of healthresort institutions at the expense of the funds of the Social Insurance Fund of Ukraine]. Resolution of the Board of the FSS of Ukraine of 2017, Pub. No. 39. (Jun 13, 2017). Ukrainian. Available from: https://zakon.rada.gov.ua/rada/show/v0039890-17#Text

ukrstat.gov [Internet]. [Health-resort and health facilities]. c1998 [cited 2022 Aug 11]. Ukrainian. Available from: www.ukrstat.gov.ua

[About recognizing some orders of the Ministry of Health of Ukraine as having lost their validity]. Order of the Ministry of Health of Ukraine of 2019, Pub. No. 448. (Feb 22, 2019). Ukrainian. Available from: http://search.ligazakon.ua/l_doc2.nsf/link1/MOZ31142.html

[The efficiency index of medical rehabilitation at the expense of the Social Insurance Fund reached 81.8%]. Uriadovyi portal [Internet]. 2022 [cited 2022 Aug 11). Ukrainian. Available from: https://www.kmu.gov.ua/news/pokaznik-efektivnosti-medichnoyi-reabilitaciyi-za-koshti-fondu-socialnogo-strahuannya-syagnuv-818

Donabedian A. Evaluating the quality of medical care. The Milbank quarterly. 2005;83(4):691-729. doi: https://doi.org/10.1111/j.1468-0009.2005.00397.x

[About the procedure for quality control of the provision of medical care]. Order of the Ministry of Health of Ukraine of 2012, Pub. No. 752. (Sep 28, 2012). Ukrainian. Available from: https://zakon.rada.gov.ua/laws/show/z1996-12#Text

Lobas VМ, Slabkyi GА, Kravets ОА. [Model of management of the medical rehabilitation process at the primary level of medical care providing]. Pytannia eksperymentalnoi ta klinichnoi medycyny: zbirnyk statei. 2013;1(17):158-63. Ukrainian.

White Book on Physical and Rehabilitation Medicine in Europe. European Physical and Rehabilitation Medicine Bodies Alliance. Eur J Phys Rehabil Med. 2018;54(2). Available from: http://www.whitebookprm.eu/2019/03/21/white-book-iii-ed-complete-pdf-version/

Stepanenko АV, Parii VD, Morozov АМ, et al. [Unified methodology for the development of local medical care protocols for health care institutions of Ukraine: methodological recommendations]. Kyiv; 2012. Ukrainian.

[Multidisciplinary working groups and topics]. [Internet]. Kyiv: State expert center. c1990-2022 [cited 2022 Aug 11]. Ukrainian. Available from: https://www.dec.gov.ua/mtd/multydysczyplinarni-robochi-grupy/

Babova ІК, Rozkov VS. [Healthresort rehabilitation of servicemen in Ukraine: public-administration aspect]. Publichne upravlinnia i administruvannia v Ukraini. 2020;19:21-26.

[List of health-resort facilities in terms of medical rehabilitation profiles for reimbursement of costs for reha¬bilitation treatment services provided to insured persons]. [Internet]. Kyiv: Social Insurance Fund of Ukraine. c2014 [cited 2022 Aug 11]. Ukrainian. Available from: http://www.fssu.gov.ua/fse/control/main/uk/publish/article/952253

[Requirements PMG 2022]. [Internet]. Kyiv: National Health Service of Ukraine. 2022 [cited 2022 Aug 11]. Ukrainian. Available from: https://contracting.nszu.gov.ua/vimogi-pmg-2022

[The tariff for rehabilitation medical services has been increased in PMG]. [Internet]. Kyiv: National Health Service of Ukraine. 2021 Marсh 09 [cited 2022 Aug 11]. Ukrainian. Available from:

https://nszu.gov.ua/novini/u-programi-medichnih-garantij-zbilsheno-tarif-na-medichni-po-496

Rehabilitation needs of people recovering from COVID-19. [Internet]. WHO: Scientific brief. 20212 Nov 09 [cited 2022 Aug 11]. Available from: https://WHO/2019-nCoV/Sci_Brief/Rehabilitation/2021.1

[In case of complications from COVID-19, employees can undergo rehabilitation at the Fund's expense]. Kyiv: Social Insurance Fund of Ukraine. c2014 [cited 2022 Aug 11]. Ukrainian. Available from: http://www.fssu.gov.ua/fse/control/main/uk/publish/article/972583

[Coronavirus disease 2019 (COVID-19)]. [Inter-net]. Kyiv: State expert center. c1990-2022 [ci-ted 2022 Aug 11]. Ukrainian. Available from: https://www.dec.gov.ua/mtd/koronavirusna-hvoroba-2019-covid-19/

Published

2022-12-29

How to Cite

1.
Bezverkhniuk T, Babova I. Ensuring of rehabilitation care quality provision: organizational-methodological aspect. Med. perspekt. [Internet]. 2022Dec.29 [cited 2024Apr.25];27(4):222-30. Available from: https://journals.uran.ua/index.php/2307-0404/article/view/271230

Issue

Section

SOCIAL MEDICINE