The proportion of people receiving specialized rehabilitation in Norway is increasing, but there is a wide variation in the content and quality of services. According to public reports, there is a need for uniform delivery and reporting of rehabilitation services, with electronic solutions that support the systematic use of good tools to evaluate the quality of services and patients' changes in goals and functioning. There is also a need for increased involvement of patients and their families, and an effective structure of cooperation that emphasizes coordinated services and continuity of rehabilitation pathways across service levels and sectors.
In this project, 17 private rehabilitation institutions have introduced the joint use of quality indicators and patient-reported outcome measures to promote improved quality and outcomes of rehabilitation.
We investigate whether the use of a quality indicator set, developed for use in rehabilitation, improves the quality and outcome of rehabilitation. In addition, we investigate the systematic use of the Directorate of Health's proposed outcome measures in clinical practice, across institutions and diagnostic groups, at measurement points ranging from the inpatient period in the specialist health service to the follow-up period at home; after 3, 6 and 12 months.
The results from the project can contribute to quality improvement of rehabilitation services locally and nationally, and strengthen the knowledge base for future recommendations regarding standardized processes, registry data and reporting routines in the rehabilitation field. Uniform reporting of rehabilitation results can make it easier for authorities to compare quality and benefits across institutions, the institutions themselves can improve the quality and content of their services, and it can be easier for patients and relatives to choose between different rehabilitation services.
The project is part of the larger RehabNytte project, which addresses the need for more experience sharing, learning and research across rehabilitation institutions and joint efforts for uniform delivery and reporting of services.
The project is a collaboration between the National Competence Center for Rheumatological Rehabilitation (NKRR) and the Research and Development (R&D) network VIRKE Rehabilitation. Recruitment of patients has been completed, and includes more than 4000 adults with various diagnoses who have received rehabilitation in the specialist health service at one of the institutions in VIRKE Rehabilitation.
The study involves:
The project also includes examining patient-reported benefits of rehabilitation, measured as changes in patients' outcome measures during the year of follow-up. In addition, we investigate the socioeconomic benefits of rehabilitation, measured by an index of quality-adjusted life years. Design: longitudinal cohort study, with subgroup analyses.