engleski

Rehabilitation of the inflammatory rheumatic diseases in the Croatian Health care system

The Croatian health care system is a good example of a coordinated network of rehabilitation services. Acute rehabilitation is provided in hospitals for acute care as intensive inpatient program. Outpatient services are available for patients who have moderate to severe physical limitations and who can travel to receive care. Home rehabilitation is developed as a viable alternative to outpatient rehabilitation for suitable patients who are not able to travel to outpatient clinics. Inpatient rehabilitation with specialized rehabilitation programs and long term rehabilitation is provided in rehabilitation hospitals. AIM The aim of this study is to analyze structure of rehabilitation in rheumatic diseases (Seropositive rheumatoid arthritis ICD-10 code M05-M05.9, Psoriatic and enteropathic arthropathies M07.0-M07.6 and Ankylosing spondylitis M45) in three different types of rehabilitation services in Croatian health care system ; outpatient rehabilitation, home rehabilitation and inpatient rehabilitation (acute rehabilitation and long term rehabilitation). METHODS Data were collected from data bases of Croatian Institute for Health Insurance. Numbers of cases of rehabilitation in rheumatic diseases in different types of rehabilitation services during 2008 were compared with total number of cases. RESULTS During 2008 in Croatian health care system 435, 303 cases of rehabilitation were determined (outpatient rehabilitation 78.0%, home rehabilitation 12.3%, and inpatient rehabilitation 9.7%). In total number of cases, 1.4% was rehabilitation in observed rheumatic diseases. In total number of rehabilitation cases during 2008 in Seropositive rheumatoid arthritis (N=3, 526) 45.2% of cases were provided as inpatient rehabilitation, 41.1% as outpatient rehabilitation and 13.7% as home rehabilitation. Structure of rehabilitation in Seropositive rheumatoid arthritis compared with total number of rehabilitation is significantly different (p<0.001, DF=2, χ2=5, 211.3, χ2 test). In total number of rehabilitation cases in Psoriatic and enteropathic arthropathies (N=1, 164) 54.9% of cases were provided as inpatient rehabilitation, 42.8% as outpatient rehabilitation and 2.3% as home rehabilitation. Structure of rehabilitation in Psoriatic and enteropathic arthropathies compared with total number of rehabilitation is significantly different (p<0.001, DF=2, χ2=2, 730.7, χ2 test). In total number of rehabilitation cases in Ankylosing spondylitis (N=1, 517) 55.9% of cases were provided as outpatient rehabilitation, 40.7% as inpatient rehabilitation and 3.4% as home rehabilitation. Structure of rehabilitation in Ankylosing spondylitis compared with total number of rehabilitation is significantly different (p<0, 001, DF=2, χ2=1700, 2, χ2 test). CONCLUSION While the inpatient rehabilitation represents every tenth case of rehabilitation in Croatian health care system, in the case of rehabilitation in observed rheumatic diseases inpatient rehabilitation is provided in 50% of patients that rehabilitation is indicated.

Rheumatic diseases ; Healthcare system ; Rehabilitation

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