Table 1 The subset of Delphi survey consensus statements that had the most direct impact on the cost model [18]
From: Cost modelling rehabilitation in the home for reconditioning in the Australian context
Category | Item No | Delphi statement |
|---|---|---|
Staff | 1 | A case manager needs to be clinical |
2 | A case manager should have administrative support | |
3 | A suitably skilled nurse/s should be part of a RITH team | |
4 | Allied health assistants have an important role to play in RITH | |
5 | Reconditioning following cancer should include psychosocial care delivered by a social worker and/or a psychologist | |
6 | If the carer is to partner in the patient’s rehabilitation (e.g. supporting therapy without a therapist present), then the RITH program must include time for carer education | |
7 | As long as team members know and understand their professional boundaries, an interdisciplinary approach can be an appropriate model of service provision for RITH for reconditioning | |
8 | The rehabilitation medicine physician should have a central role in the provision of RITH, as they do in inpatient rehabilitation units | |
Program features | 9 | Admission to inpatient rehabilitation should be available to RITH patients where progress has failed, and inpatient rehabilitation may assist |
10 | RITH programs should not accept medically unstable patients | |
11 | The patient’s RITH care plan should include an indicative number and type of therapy interventions | |
12 | An acceptable key performance indicator (KPI) for subsequent admission to inpatient rehabilitation following a ‘failed’ RITH for reconditioning program is ≤ 10% | |
13 | In a well-functioning RITH program, acute hospital readmission rates should be as low as or lower than acute hospital readmission rates following inpatient rehabilitation | |
14 | Multi-disciplinary team case conferences should feature in each patient’s RITH program | |
15 | RITH patients should receive as comprehensive a rehabilitation service as they would have received if they had been undergoing inpatient rehabilitation | |
16 | Technology can be an effective means for a rehabilitation physician to monitor a patient’s progress during RITH | |
Budgetary features | 17 | The cost of a patient’s individual RITH program should be no more than the cost of a comparable inpatient rehabilitation episode |
18 | A RITH service could use an external brokerage model to provide personal care, home help and meals when required by patients while they undergo RITH | |
19 | When required, paid support services (e.g. personal care, home help, meal services) should be available to patients on RITH programs, irrespective of whether they have a carer or not |