장애인 방문재활제도 도입 방안 고찰: 국내외 사례를 중심으로

Abstract

Disabled patients often have poor health conditions and a high medical cost burden. According to a survey, the second-largest health care service that should be strengthened for the disabled was home-based rehabilitation. Accordingly, laws were revised and a pilot project was implemented, but the results were still insufficient. This study reviewed home-based rehabilitation in Korea and foreign countries. Data, such as laws, information on related organizations, and research reports, were collected for each country. Korea provided home-based rehabilitation for convalescent and chronic patients through National Health Insurance. Homebased rehabilitation is provided by a multidisciplinary team including doctors, nurses, and therapists, and doctors are qualified as specialized in rehabilitation medicine. In foreign countries, such as Japan, the United States, Australia, and Singapore, doctors, nurses, therapists, and other specialists belonging to primary institutions provide comprehensive home-based health and medical services including rehabilitation. There is no requirement for physician specialization, and in some countries, a doctors’ prescription is not necessary for home-based rehabilitation. Medical cost varies depending on the service content and healthcare payment system of each country. In Singapore, Home Environment Review service is part of Home Therapy, and the therapist assesses, improves, and links resources to support the home risk factors. It is difficult to apply home-based rehabilitation to all disabilities due to differences in conditions and required treatment. This assessment requires careful consideration from multiple perspectives.