Cost-effectiveness of an integrated 'fast track' rehabilitation service for multi-trauma patients involving dedicated early rehabilitation intervention programs: design of a prospective, multi-centre, non-randomised clinical trial

Abstract

Background: In conventional multi-trauma care service (CTCS), patients are admitted to hospital via the accident & emergency room. After surgery they are transferred to the IC-unit followed by the general surgery ward. Ensuing treatment takes place in a hospital's outpatient clinic, a rehabilitation centre, a nursing home or the community. Typically, each of the CTCS partners may have its own more or less autonomous treatment perspective. Clinical evidence, however, suggests that an integrated multi-trauma rehabilitation approach ('Supported Fast-track multi-Trauma Rehabilitation Service': SFTRS), featuring: 1) earlier transfer to a specialised trauma rehabilitation unit; 2) earlier start of 'non-weight-bearing' training and multidisciplinary treatment; 3) welldocumented treatment protocols; 4) early individual goal-setting; 5) co-ordination of treatment between trauma surgeon and physiatrist, and 6) shorter lengths-of-stay, may be more (cost-)effective.

Experiences of Encountering Physical Trauma Caused by Traffic Accidents: A Qualitative Study

“…The research indicates that many people may experience a noticeable level of functional and performing limitations. Also Aitkin et al (2007) reported that the functional limitations in the injured people may be seen in different areas such as physical and social functioning, mental health, emotional role, and general health [13][14][15][16][17][18]. Russel study (2008) which was about hospitalized trauma patients one year after the accident has shown that 30% of the hospitalized patients had significant limitations in different aspects of functioning and performing.…”

“…Russel study (2008) which was about hospitalized trauma patients one year after the accident has shown that 30% of the hospitalized patients had significant limitations in different aspects of functioning and performing. Based on this study, 77% of the 48 hospitalized trauma patients had a mild disability and 23% had an average level of disability [13][14][15][16][17][18][19][20].…”

Fast Track in der Unfallchirurgie

“…Leider gibt es hierzu keinerlei Daten, welche Vorteile eine frü-he und schnelle Rehabilitation im Sinne eines Fast-Track-Progamms bringen kann. Es existiert eine Veröffentlichung eines Studienprotokolls aus den Niederlanden von der Arbeitsgruppe um Kosar et al [7], in der genau diese Frage geklärt werden soll.…”

Therapeutic Model of Rehabilitation: The Contribution of Nursing «Supported Fast Track Multi-Trauma Rehabilitation Services»

“…This experimental study, in addition to proposing a reduction of the proportion of health problems resulting from trauma itself, crucial to the loss of functionality and independence, presents a set of other ideal characteristics that support the development and implementation of evaluation processes of the disabled patient's/family's needs, thereby allowing the early and timely planning of the most appropriate solutions, support and compensation interventions (Hoffman, et al, 2014;Siddiqui, Woanwui & Kwong Fah, 2014;Paiva, et al, 2012;Van Horn, 2009;Alves, et al, 2009;. Kosar, et al, 2009;De Carlo, et al, 2007).…”

“…3(2), December 2016 «Supported Fast Track Multi-Trauma Rehabilitation Service» proposes a model which aims at a more integrated, flexible and cross-functional approach, focused on the needs of the patient/family (from the hospital admission Stage, to the full reintegration in the community) and, therefore, at an improved quality of life (Kosar, et al, 2009). …”