The new look in rehabilitation.

D E Eazell
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Abstract

In the 1990s, operational strategies to assure survival will be crucial for all healthcare providers. All will face an accelerating rate of change, and the paramount change will be an intensified competitive marketplace. How does this impact rehabilitation? Like acute care hospitals, rehabilitation facilities will diversify into alternative delivery systems. This paper examines the course one provider--Casa Colina, Inc.--has taken, the pitfalls and problems along the way, and the implications for other rehabilitation providers. Strategies used to strengthen various areas of rehabilitation are considered, including ambulatory care, skilled nursing, traumatic brain injury, medical and vocational rehabilitation, residential programs, joint ventures, rehabilitation hospitals and outpatient services. A strong consensus exists today among healthcare experts concerning where we are headed and operational strategies for survival in 1990. How does this consensus impact rehabilitation? Before dealing with rehabilitation, let us review essential agreements. For HOSPITALS, the experts agree that: multi-hospital systems will continue to grow and will be best positioned to implement and take advantage of the strategies of choice in the new competitive market; money spent nationally on healthcare services will continue to grow; new types of providers will erode acute care inpatient hospitals' share of healthcare expenditures; emphasis in healthcare will shift to ambulatory services and delivery systems; and hospitals may be at a disadvantage in attracting capital financing and many will have to create new corporate structures and business ventures to compete in the capital market.(ABSTRACT TRUNCATED AT 250 WORDS)

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康复的新面貌。
在20世纪90年代,确保生存的业务战略对所有医疗保健提供者至关重要。所有这些都将面临加速变化的速度,而最重要的变化将是竞争加剧的市场。这对康复有什么影响?与急症护理医院一样,康复设施也将多样化,提供不同的服务体系。本文考察了一家康复服务提供商——Casa Colina, Inc.——所采取的课程,沿途的陷阱和问题,以及对其他康复服务提供商的影响。审议了用于加强各个康复领域的战略,包括流动护理、熟练护理、创伤性脑损伤、医疗和职业康复、住宿方案、合资企业、康复医院和门诊服务。今天,保健专家就我们的前进方向和1990年生存的业务战略达成了强烈的共识。这种共识如何影响康复?在讨论康复之前,让我们回顾一下基本协议。就医院而言,专家一致认为:多医院系统将继续发展,并将在新的竞争市场中最有利地实施和利用选择战略;全国用于医疗保健服务的资金将继续增长;新型医疗服务提供者将侵蚀急症住院医院在医疗支出中的份额;医疗保健的重点将转向门诊服务和提供系统;医院在吸引资本融资方面可能处于不利地位,许多医院将不得不创建新的公司结构和商业企业,以便在资本市场上竞争。(摘要删节250字)
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