Rehabilitation goals of people with spinal cord injuries can be classified against the International Classification of Functioning, Disability and Health Core Set for spinal cord injuries

Objectives: To establish whether inter-professional rehabilitation goals from people with non-traumatic spinal cord injury (SCI) can be classified against the International Classification of Functioning, Disability and Health (ICF) SCI Comprehensive and Brief Core Sets early postacute situation. Setting: Neurological rehabilitation unit. Methods: Rehabilitation goals of 119 patients with mainly incomplete and non-traumatic SCIs were classified against the ICF SCI Core Sets following established linking rules. Results: A total of 119 patients generated 1509 goals with a mean (and s.d.) of 10.5 (9.1) goals per patient during the course of their inpatient rehabilitation stay. Classifying the 1509 rehabilitation goals against the Comprehensive ICF Core Set generated 2909 ICF codes. Only 69 goals (4.6%) were classified as ‘not definable (ND)’. Classifying the 1509 goals against the Brief ICF Core Set generated 2076 ICF codes. However, 751(49.8%) of these goals were classified as ‘ND’. In the majority of goals (95.7%), the ICF code description was not comprehensive enough to fully express the goals set in rehabilitation. In particular, the notion of quality of movement or specificity and measurability aspects of a goal (usually described with the criteria and acronyms SMART) could not be expressed through the ICF codes. Conclusion: Inter-professional rehabilitation goals can be broadly described by the ICF Comprehensive Core Set for SCI but not the Brief Core Set

Canon 11: Gezondheidseconomie

Ruim vijftig jaar geleden verscheen het klassieke artikel van Arrow, ‘Uncertainty and the welfare economics of medical care’ (Arrow, 1963). Algemeen wordt dit gezien als beginpunt van de gezondheidseconomie als afzonderlijke discipline. Sindsdien heeft de gezondheidseconomie een stormachtige ontwikkeling doorgemaakt, parallel aan het sterk groeiende aandeel van de gezondheidszorg in de economie. Dit is geen toeval, want wereldwijd worstelen beleidsmakers met de vraag hoe zorg voor iedereen toegankelijk en betaalbaar kan worden en blijven. De klassieke economische vraag hoe de schaarse middelen zo doelmatig en rechtvaardig mogelijk kunnen worden verdeeld, speelt bij uitstek in de gezondheidszorg. In deze canon van de gezondheidseconomie komen negen inzichten aan bod die de gezondheidseconomie de afgelopen vijftig jaar heeft opgeleverd