The move towards community-based rehabilitation in industrialised countries: are we equipped for the challenge?
BACKGROUND
Recent challenges to health systems in industrialised countries (e.g., health trends, workforce shortages, geographical dispersion, changing demographics and the growing demand for hospital beds) have prompted a rise in popularity of services loosely labelled community-based rehabilitation (CBR). The rise of CBR is based on the assumption that these models of service delivery have the potential to address some of these challenges by promoting efficient use of community resources. However, due to the way in which CBR has evolved in industrial countries, there is considerable ambiguity surrounding the concept, and even more uncertainty about the methods by which its implementation can be fostered.


OBJECTIVE
To explore the CBR in an industrialised country and the implications of its implementation for the health workforce, health systems and service delivery.


METHODS
This article reviews existing literature to explore the concept of CBR as it is applied in industrialised countries. It examines the possible implications of adopting CBR into health systems, including the need for conceptual clarity, a competency frameworks and ongoing professional development.


CONCLUSIONS
This article has shown that for CBR is to become a viable model for the delivery of health services in industrialised countries, a competency framework is needed, together with strong leadership to facilitate the translation of theory into practice. Further, collaboration is required among practitioners, policy makers, unions, consumers, educators and professional associations to support this transformation.
Kendall
Elizabeth
E
Research Centre for Clinical and Community Practice Innovation & Centre of National Research on Disability and Rehabilitation Medicine, Logan Campus, Griffith University, Australia. e.kendall@griffith.edu.au
Muenchberger
Heidi
H
Catalano
Tara
T
D003142:Communication; D003153:Community Health Services / Q000458:organization & administration* / Q000639:trends; D003256:Community Participation; D003695:Delivery of Health Care / Q000458:organization & administration; D019049:Developed Countries; D006302:Health Services Research; D006801:Humans; D007400:Interprofessional Relations; D017146:Models, Organizational; D012046:Rehabilitation / Q000458:organization & administration* / Q000592:standards / Q000639:trends