Status of the community-based rehabilitation in china reflected from multilevel medical institutions

Abstract

The study was conducted to investigate the status of community-based rehabilitation in China, and to provide evidence for the formulation of relevant policies. From January to February in 2018, questionnaires were sent to the rehabilitation departments from 23 provinces, 4 municipalities and 5 autonomous regions in China. The questionnaire had 4 versions, for rehabilitation department (community hospital/general hospital), non-rehabilitation department (community hospital/general hospital). The questionnaires covered the configuration of equipment, professionals in community rehabilitation department and the deployment of community-based rehabilitation services. In total, 1798 valid questionnaires were retrieved, of which 434 were community hospital version (210 rehabilitation and 224 non-rehabilitation), 1364 were general hospital version (1118 rehabilitation and 176 non-rehabilitation). Among all the survived community hospitals, 54.4% of which had rehabilitation clinics, 51% had rehabilitation doctors, 60% had therapists and 33.4% had rehabilitation wards, 55.6% of rehabilitation department of community hospital receive < 500 patients per month. Rehabilitation department in community receive most patients with dysfunction after brain damage due to various reasons. More than 70% of rehabilitation department in community conducted therapeutic exercise, traditional Chinese medicine rehabilitation and therapeutic physical agents, and the rate of occupational therapy, language therapy, deglutition training and family rehabilitation indication were less than 50%. Only 27.8% of rehabilitation department in community has referral business with superior rehabilitation institutions, and nearly half of staff had no access to higher level rehabilitation training. The community rehabilitation in China has witnessed a rapid development over the past decade, but there are still many problems to be solved. A lack of corresponding medical policies, unbalance of regional development, relative weak basic construction, incomplete training system of community talents are all unsolved problems. With the growing problem of aging in China, the demand for community rehabilitation will increase day by day, which puts forward new challenges to China's medical and health decision-making.