Increasing availability of medical rehabilitation services

Date

2022 12 29

Rating

As of 1 January, patients will have a faster and simpler access to medical rehabilitation services. Primary medical rehabilitation services will be prescribed based on the condition of the patient's health, the degree of functional impairment, but not specific diseases or diagnosis. Supportive rehabilitation services will be more available to elderly residents, while children with blood and lymph diseases will be able to use not only inpatient, but also outpatient rehabilitation services. Patients with more serious conditions, when timely rehabilitation is crucial, will be able to use the ‘green corridors’ without having to wait in queue.

According to the new procedures, medical rehabilitation services will be prescribed by a physical medicine and rehabilitation (PMR) doctor. Until now, rehabilitation was prescribed by a family doctor, taking into account the conclusions of their consultation. Thus, from now on, the patients’ path in seeking for rehabilitation services will be shorter, while doctors will benefit from a reduced administrative burden.

More patients will receive the services they need

Expanding the conditions for prescribing rehabilitation will make it available to a larger number of patients. As of 1 January 2023, supportive rehabilitation services will also be available to retired persons with recognized moderate level of special needs. Currently, these services are available only to retired persons with level of special needs.

The renewed procedures also provide another new service provision profile or children with blood and lymph diseases. Until now, these children were provided with inpatient rehabilitation services only, while as of the next year they will be able to receive outpatient rehabilitation services that are closer to home too.

Patients with severe diseases, released from hospital, for whom the speed and quality of receiving rehabilitation services are especially important, will be able to use ‘green corridors’. They will not need to wait in general queue, thus enabling to start rehabilitation earlier in order to recover the impaired biopsychosocial functions as fast and effective as possible, or, in case of irreversible changes, to compensate them and ensure the smoothest recovery process possible. This is particularly important for people after various traumas, strokes, heart attacks, complex surgeries, also patients with chronic and oncological diseases.

Reduced administrative burden on doctors

As of 1 January 2023, the assessment of the patient health condition and need for rehabilitation will become more individual, abandoning the use of disease codes in some areas. This means that the prescription of outpatient medical rehabilitation services will not be associated with a specific disease code, and services will be prescribed based on the general diagnosis of the disease and biopsychosocial function disorders. For example, based on the new procedure, someone with diagnosed ‘respiratory system tumours’ will have the outpatient rehabilitation services after surgery or specific treatment reimbursed regardless of the specific code of the disease.

In order to help doctors assess their patient's state of health as accurately as possible and prescribe the most effective treatment, the new procedure specifies disease codes, biopsychosocial function disorders, degrees of severity of the disease, rehabilitation duration when providing initial, outpatient, inpatient medical rehabilitation or anti-recidivism sanatorium treatment services.

In each specific case, a PMR doctor will have to assess the patient’s health condition, degree of the severity of the disease, and biopsychosocial function disorders to decide on the expediency, type and time of medical rehabilitation. Prescribing rehabilitation, a PMR doctor will be able to issue or extend the validity of the certificate of incapacity to work. The doctors themselves will find a reduced administrative burden, as they will need to fill out fewer electronic forms on the e-health system.

Introduction of an advanced assessment system

Further improvement of the rehabilitation service provision procedure, Lithuania is starting to introduce the Functional Independence Measure (FIM). The purpose of this measure is to assess the condition of the patient's health, the need for rehabilitation services and their efficiency, enabling to ensure quality and efficient rehabilitation services for all patients in Lithuania.

The obligation to start applying FIM for the assessment of patients that come for rehabilitation after diseases of the nervous system or damage to the musculoskeletal system as of 1 November 2023 was certified by an order of the Minister.

Press Service of the Ministry of Health

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