Alternative to supply of health services in physical medicine and rehabilitation: From mobile team to home hospitalization

Abstract

In France, the notion of care pathway is enshrined in the circular of March, 2012 relative to the organization of care for patients’ victim of stroke. The rehabilitation-reinsertion mobile team of the pole Saint-Helier (EM2R) was created in 2012 in this context, with support from the Regional Health Agency of Brittany. The main mission of this newly created team is to implement the necessary devices to facilitate the home returning of people hospitalized after a neurological event or maintain home people with neurological disorders (more than 200 coverage a year). The neurodegenerative diseases plan of 2014–2019 points, especially in its 15th measure, that we shall remove all things slowing down the hospital care access at home for people with neurodegenerative diseases and this no matter where they live. And this is done mainly through mobile teams and home medical care (HAD in France) activities. In coherence with the activities recently developed “outside the walls” by the pole Saint Helier (EM2R and telemedicine), the establishment of a HAD-SSR (home medical care of rehabilitation care), further consolidated the healthcare pathway for people with disabilities.This activity has been developing since September, 2017 in relation with the HAD 35 and two rehabilitation centers which provide reeducation professionals’. 15 patients have already been cared, mostly persons with stroke. The aim is to ensure a global, coordinated and specialized care by bringing to patients’ home a variety of expertise in the field of rehabilitation: doctors of physical medicine and rehabilitation, physiotherapists, occupational therapists, speech therapists, neuropsychologists… and to propose an additional alternative to hospitalization in rehabilitation care when the situation permits it in the healthcare pathway of people with disabilities.