[Texts ruling activity in nursing homes and rehabilitation institutions in France, from the 9th March 1956 decree to the 17th April 2008 decrees. Part of physical medicine and rehabilitation].
In France, inpatient care is provided in three different sectors: "medicine, surgery and obstetrics", "follow-up care and rehabilitation" (soins de suite et de réadaptation=SSR) and "long-term care". Physical medicine and rehabilitation is involved mainly in SSR. As of April 2008, there are new regulations aiming to improve prior texts, to implement rules that will be identical for public and private sectors and to prepare for the new payment-by-the-act funding system (in place of the prior global funding). Now, all SSR structures have a common general basis in terms of purpose and means and specific rules for various specialties. For example, coordination of a multidisciplinary team in specialized facilities dealing with musculoskeletal and nervous system disorders must be conducted by a physical medicine and rehabilitation (PMR) specialist. Patient admission criteria still need to be defined, as does the assessment of therapeutic objectives. The expertise of SSR facilities is recognized by the possibility of direct admission from home for ambulatory patients. Nevertheless, many specifics are missing in these new decrees. These specifications will be elaborated on a regional basis, in future endeavours within regional healthcare organizations.
Yelnik
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Service de médecine physique et de réadaptation, groupe hospitalier Lariboisière-Fernand-Widal, AP-HP, université Paris-7, 200, rue du Faubourg-Saint-Denis, 75475 Paris cedex 10, France. alain.yelnik@lrb.aphp.fr
D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D002648:Child; D005602:France; D006296:Health Services / Q000331:legislation & jurisprudence; D006801:Humans; D008134:Long-Term Care; D009735:Nursing Homes / Q000331:legislation & jurisprudence*; D010810:Physical and Rehabilitation Medicine / Q000331:legislation & jurisprudence*; D012046:Rehabilitation / Q000331:legislation & jurisprudence*; D012047:Rehabilitation Centers / Q000331:legislation & jurisprudence*; D012943:Social Security / Q000331:legislation & jurisprudence