Clinical management reviewModels for Integrating Rehabilitation and Primary Care: A Scoping Study
Section snippets
Methods
The scoping study is an emerging methodology for literature synthesis,20 defined as a way of mapping key concepts within a research area by assembling multiple sources and types of evidence available. The emphasis of a scoping study is on comprehensive coverage, rather than on a particular standard of evidence. This approach permits identification of strengths and weaknesses in a body of literature, as well as high-level conceptual observations. Concepts that emerge from the review may either
Clinic
The most common model for integrating rehabilitation services and primary care is the clinic approach. The typical configuration of this type of practice is for a rehabilitation professional, such as an occupational or physical therapist, to work out of an examining room in a family practice. The key to this model is that family physicians and rehabilitation professionals are colocated, resulting in a geographically defined team. The role of professionals is to exercise their usual scope of
Discussion
In summary, we undertook an extensive review of rehabilitation and primary care literature covering a 13-year period. Six models were identified for integrating rehabilitation and primary care services, to better serve the health needs of people with chronic diseases and disabilities. The most common models were clinic and outreach. Less common, but worthy of consideration were case management, self-management, shared care, and CBR.
A number of themes were identified across models that may act
Conclusions
Despite the enumerated challenges, this review offers 6 ways in which those committed to the service of people with disabilities might relate to one another in a community primary health care setting. The default approach, and by far the most common, is the clinic approach. Although this approach is familiar to virtually all types of health professionals, it is only one way to promote the collaborative care that is so clearly advocated as the means to not only enhance the provision of primary
References (71)
- et al.
Access to health care services among people with chronic or disabling conditions: patterns and predictors
Arch Phys Med Rehabil
(2003) Breaking down barriers: integrating health and care services for older people in England
Health Policy
(2003)- et al.
Integrated care: the impact of governmental behaviour on collaborative networks
Health Policy
(1999) - et al.
Co-financing as a means to improve collaboration between primary health care, social insurance and social service in SwedenA qualitative study of collaboration experiences among rehabilitation partners
Health Policy
(2003) - et al.
Predictive factors for 1-year outcome of low-back and neck pain in patients treated in primary care: comparison between the treatment strategies chiropractic and physiotherapy
Pain
(1998) - et al.
Interdisciplinary collaboration within Quebec community health care centres
Soc Sci Med
(2002) - et al.
A trial of an activating intervention for chronic back pain in primary care and physical therapy settings
Pain
(2005) - et al.
Multidisciplinary rehabilitation versus usual care for chronic low back pain in the community: effects on quality of life
Spine J
(2003) - et al.
Primary care quality in the Medicare program: comparing the performance of Medicare health maintenance organizations and traditional fee-for-service Medicare
Arch Intern Med
(2002) - et al.
Satisfaction with quality and access to health care among people with disabling conditions
Int J Qual Health Care
(2002)
Another way to look at high service utilization: the contribution of disability
J Health Services Res Policy
Rates of access to assistive equipment and medical rehabilitation services among people with disabilities
Disabil Rehabil
Experiences with care co-ordination among people with cerebral palsy, multiple sclerosis, or spinal cord injury
Disabil Rehabil
Improving population health and chronic disease management
Utilization, access and satisfaction with primary care among people with spinal cord injuries: a comparison of three countries
Spinal Cord
Preventing disability through community-based health coaching
J Am Geriatr Soc
The future of primary care: transforming practice
N Engl J Med
Physician experiences providing primary care to people with disabilities
Healthc Policy
Structural determinants of access to health services for people with disabilities
The need for integrated primary health care to enhance the effectiveness of health services
Asia Pac J Public Health
The decline of family practice as a career in Ontario: a discussion paper on interventions to enhance recruitment and retention
The future of primary care: reforming physician payment
N Engl J Med
Five laws for integrating medical and social services: lessons from the United States and the United Kingdom
Milbank Q
No place like home—testing a new model of care delivery
N Engl J Med
Scoping studies: towards a methodological framework
Int J Soc Res Meth
Clinicians, services and commissioning in chronic disease management in the NHS: the need for coordinated management programmes: report of a Joint Working Party of the Royal College of Physicians of London, the Royal College of General Practitioners and the NHS Alliance 2004
Mental health link: the development and formative evaluation of a complex intervention to improve shared care for patients with long-term mental illness
J Eval Clin Pract
Transcending the technology of telemedicine: an analysis of telemedicine in North Carolina
Health Commun
Building a medical neighborhood for the medical home
N Engl J Med
Innovative care for chronic conditions: building blocks for action
Evaluation of the effect of co-financing on collaboration between health care, social services and social insurance in Sweden
Int J Integr Care
Primary health care: six dimensions of inquiry
How to manage the implementation of shared care: a discussion of the role of power, culture and structure in the development of shared care arrangements
J Manag Med
Professional identities and interprofessional relations: evaluation of collaborative community schemes
Soc Work Health Care
Cited by (92)
Supporting government policies to embed and expand rehabilitation in health systems in Europe: A framework for action
2022, Health PolicyCitation Excerpt :Primary care, as elaborated in the recent Astana Declaration, is the cornerstone of UHC [114] and integrated care [112,115] and should therefore be strengthened to better respond to the rehabilitation needs of person with disability [116,117]. Health systems have approached the integration of rehabilitation in primary care differently which reflects the contextual dynamics that influence the organization of care [118]. Sweden provides an example of how home rehabilitation can be better provided by a coordinated network of primary care professionals (Fig. 2).
Occupational therapy services in primary care: A scoping review
2023, Primary Health Care Research and DevelopmentRehabilitation in primary care for an ageing population: a secondary analysis from a scoping review of rehabilitation delivery models
2024, BMC Health Services ResearchLGBTQ+ in workplace: a systematic review and reconsideration
2024, Equality, Diversity and InclusionMultidisciplinary rehabilitation for Parkinson’s disease
2024, Cochrane Database of Systematic Reviews
Supported by the Ontario Ministry of Health and Long-Term Care, Ontario Rehabilitation Research and Advisory Network, and Ontario Neurotrauma Foundation.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.