Reply To: Discussion Forum 3

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I work in a busy, NYC hospital as a physical therapist. A huge part of our job is doing an initial evaluation of a patient in the hospital and assessing their rehabilitation needs upon discharge from the medical hospital. Patients can be discharged anywhere on the continuum of care from no rehab needs at all, up to inpatient acute care rehabilitation. Acute rehab is loosely defined as a multidisciplinary needs (PT,OT &/or SLP), ability to tolerate at least 3 hours of therapy a day, and achievable goals within a short time frame (~5-21 days). In between these two endpoints are home service, going home and attending community – or “outpatient” services, or “subacute” rehab which is inpatient rehab for those unable to tolerate a full three hours a day and/or have rehab goals/expectations spanning longer than 2-3 weeks.
In short, there are ample services available in NYC. The frustrating part is ACCESS to, and payment for services. For the small minority of patients who can afford the best services, they have it all at their fingertips. For most, they are restricted by what their insurance covers. There are patients who go home and require outpatient services but have a co-payment for each visit. Some patients have co-pays as high as $50 a visit. That cost, times multiple visits a week is prohibitive and discourages patients from fully utilizing services available.
I am interested in how to firstly ensure that these services are available in other countries, but also that they are accessible.