Patient rehabilitation in hospitals a prioritized discipline after hospital reform: a Norwegian perspective.
OBJECTIVE
The purpose of the present study was to highlight the effects of hospital reform introduced in Norway 2002 on patient rehabilitation.


BACKGROUND
The Norwegian hospital reform is an activity-controlled financing system with diagnosis-related groups (DRG).


METHODS
A multi-case study with embedded design methods was used. Document analysis and interviews are sources of evidence.


RESULTS
The rehabilitation service offered a treatment service that was inadequately funded. The focus of the rehabilitation team was negatively affected by the lack of organization. The different patient groups did not receive optimal and individualized rehabilitation as required by individual treatment plans. There were two different levels of rehabilitation at the hospitals.


CONCLUSIONS
The financing system did not provide for a differentiated treatment service tailored to each patient's individual plan, as stipulated by health policy. An increase in the number of patients receiving rehabilitation in the health authorities was not accompanied by an increase in allocated resources, leading to an insufficient overall rehabilitation service. The organizations included in the case study were not those who finance specialized rehabilitation at specialized rehabilitation centres.


CONCLUSIONS
Specially trained nurses are strategically placed to shape and influence funding of rehabilitation programmes through leadership.
Tingvoll
Wivi-Ann
WA
Department of Health and Society Science, Narvik University College, Narvik, Norway. wivi-ann.tingvoll@hih.no
Snelltvedt
Torill
T
Haggblom
Anette
A
D003362:Cost-Benefit Analysis; D003953:Diagnosis-Related Groups / Q000191:economics*; D004526:Efficiency; D017598:Efficiency, Organizational / Q000191:economics; D005376:Financial Management; D017048:Health Care Costs; D018166:Health Care Reform / Q000191:economics*; D006291:Health Policy; D006801:Humans; D007857:Leadership; D009664:Norway; D009741:Nursing Staff, Hospital / Q000191:economics* / Q000458:organization & administration; D009745:Nursing, Supervisory / Q000191:economics* / Q000458:organization & administration; D019145:Rehabilitation Nursing / Q000191:economics*