The report is available in English with a French summary - KCE

KCE reports 57 Musculoskeletal & Neurological Rehabilitation 151
8 INTERNATIONAL COMPARISON
8.1 GENERAL INTRODUCTION
This part of the research focuses on a search for international experiences with the
reorganisation of the rehabilitation sector. As rehabilitation is organized differently for
children and adolescents (age 17 years), we focus on the
adults.
The aim of this chapter is to describe experiences in the (policy) choices made in
organising the musculosceletal and neurological rehabilitation in a selection of countries.
The organisation of any health care sector has to be understood in general, against the
background of historical policy choices. Within the practical constraints of this research,
the study contextualises the organisation of the rehabilitation sector within the overall
health care system. Rehabilitation approaches develop within the features of insurance
models, competency domains of central and decentralised agencies and local problems
of health care provision.
8.1.1 Research questions in this part of the study
8.2 METHODS
8.2.1 Selection of the countries
• How does a selected sample of countries organise and finance (postacute)
musculoskeletal and neurological rehabilitation?
• What are the current health service debates and organisation models
proposed and developed for the post-acute musculoskeletal and
neurological rehabilitation sector?
• Are there any specific quality initiatives taken related to the
organisation of the post-acute musculoskeletal and neurological
rehabilitation sector?
• Can anything be learned about the organisational choices made in
different countries for the current Belgian debate on post-acute
musculoskeletal and neurological rehabilitation?
• What choices are made for some of the selected pathology groups?
Of course, the practical constraints of the research limited the number of countries to
be compared. The selection of the countries, was based on criteria related to the health
care system, developments in the rehabilitation sector, previous research experience in
rehabilitation and an endorsement of the selection by the external expert group.
Countries were selected based on the role of the state, the role and model of health
insurances (private, public, mixed models) and knowledge about ongoing debates in the
reorganisation of the rehabilitation sector. A selection was made of countries
developing their health systems in a more North European tradition, a more south-
European tradition, and countries in which insurers are taking over an important role as
catalysts in the organisation of health services
A decision was made to focus on a description of the rehabilitation sector in: The
Netherlands, France, Sweden, Germany and the US.
8.2.2 Peer-reviewed journals
A first step, aiming at describing the organizational models of rehabilitation for the
selected countries, consisted of searching the Medline database (through PubMed).