FUNCTIONAL AND ORGANIZATIONAL MODELS OF REHABILITATION CARE FOR PEOPLE WHO HAVE UNDERGONE CEREBRAL STROKE AT THE REGIONAL LEVEL

Abstract

Goal of study – to justify and develop a functional and organizational model for providing rehabilitation care to individuals who have undergone cerebral stroke at the regional level under conditions of limited resources.
Object and methods of study. The system of rehabilitation care for neurological patients was the object of study. Methods of systematic approach, conceptual modeling and statistical one were applied to achieve the goal of the study.
Results and their discussion. According to the results of the analysis of official data from medical reports on morbidity, prevalence and screening coverage of all forms of brain strokes in Transcarpathian region for 2014-2017 the estimated number of persons who may need rehabilitation care after undergoing cerebral stroke was determined. Thus, the rehabilitation care of different volume annually may be needed for at least 1800-1900 persons of this group in Transcarpathian region. Due to the fact that the volume and types of rehabilitation care significantly depend on the degree of severity of the disease itself and the severity of its effects, three categories of rehabilitation programs patients were identified by types and the severity of function violations after cerebral stroke. In particular, the I category includes the light degree of defeat, II and III categories – middle and severe degree of lesion, respectively. A list of criteria for classifying the person to each of the categories of patients’ rehabilitation programs is developed.
For Rational functional and organizational models of rehabilitation of persons after cerebral stroke were developed and justified for each of the categories. Each model is divided into stages, the personnel of the multidisciplinary team for providing each stage is grounded and the main functions of its members are defined. The structural features of the models for each type of patients after cerebral stroke are defined and the functions of the team's key stakeholders are outlined. Separately the role of the middle environment of the patient as an individual structural element of the model is described.
Conclusions.
1. Cerebral strokes and their consequences are an extremely topical social and medical problem of the health care industry that requires considerable efforts both on the part of medical and rehabilitation care to solve it. Thus, according to estimated data each year comprehensive rehabilitation care after cerebral stroke is needed by at least 1800-1900 people in Transcarpathian region.
2. In the conditions of limited resources (staff and logistical) for the system of rehabilitation care at the regional level it is advisable to divide patients after cerebral stroke by categories depending on the type and the severity of functions violations after cerebral stroke for the development and implementation of rational functional and organizational rehabilitation models for patients after cerebral stroke.
3. The developed functional and organizational models of patients’ rehabilitation after cerebral stroke depending on the category of rehabilitation programs patients according to the types and lesions of functions will give an opportunity to rationally use the available resources preserving the maximum of medical and social rehabilitation effect.