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Often, after an illness or accident, the doctor will refer you to rehabilitation. What kind of benefits are you en titled to and what treatments can you count on?
The goal of rehabilitation is to restore full or achievable physical and mental fitness, ability to work and earn money, and to take an active part in social life. This is the definition of the World He alth Organization (WHO). Under the insurance, you can use three forms of outpatient rehabilitation. The first is the procedures for which the patient comes to the clinic. The second is rehabilitation in a day ward, and the third - treatments performed at the patient's home.
Rehabilitation is directed by a he alth insurance doctor. The referral must include: a header stamp with the number of the contract with the National He alth Fund, all patient data and diagnosis in Polish, disease code, description of dysfunction, reasons for referral to rehabilitation, past and coexisting diseases. The form must include a stamp, doctor's signature and the date of issue. The referral must be accompanied by a set of tests justifying the need for such therapy. The referral will expire if it is not registered within 30 days from the date of issue.
In the clinic
Outpatient rehabilitation includes medical advice and physiotherapy treatments. Referrals for certain treatments, such as basic electro and magnetotherapy treatments, can be issued by any he alth insurance doctor. The exception is patients with motor organ dysfunction caused by posture defects. In such a situation, the referral is issued by a doctor of a medical rehabilitation clinic or an orthopedics and traumatology clinic. The doctor may order no more than 5 types of treatments. Patients referred to physical therapy treatments may take advantage of a maximum of 10 treatments in one treatment cycle for one body area (e.g. knees are two areas!). If there is a need for long-term treatment of chronic diseases, the doctor may refer you for 20 treatments. Kinesiotherapy classes are conducted individually or in groups. In the case of a cryochamber, there is a special limit - a patient under the National He alth Fund may take advantage of 20 treatments per year. After the treatments or exercises, the patient signs on a special form to confirm that the treatments were performed on a given day.
In day care
If the patient requires a longer onerehabilitation or more intensive exercises and treatments, and he may come to the clinic, he is referred to the day ward. This form of medical care is usually used by people after injuries, surgeries, as well as chronic, neurological, rheumatological and oncological diseases. The day center is referred to by the doctors of the trauma-orthopedic, surgical, neurosurgical, rheumatology, oncology, urology, gynecology and internal medicine departments. In the event of exacerbation of chronic diseases, referrals may be issued by rehabilitation, trauma-orthopedic, neurological and rheumatology clinics, as well as primary care or family physicians. This form of rehabilitation is carried out for a period of 3 to 6 weeks. Patients visit the clinic 5 days a week, where they spend about 4 hours. During this time, they must have at least 5 treatments. Each day of treatment must be certified by the patient's signature.
The doctor always decides
In many rehabilitation clinics that have signed agreements with the National He alth Fund, you can use kinesis and physical therapy treatments also on a commercial basis. However, it is worth remembering that even if you want to pay for rehabilitation out of your own pocket, you should ask the physiotherapist to choose the right set of exercises or treatments for you. This is important because we are not able to choose, for example, the dose and time of exposure, and the wrong combination of treatments can destroy their therapeutic value. There are also many contraindications to using certain physical therapy procedures, e.g. atrial fibrillation, implanted pacemaker, etc.
At the patient's home
Rehabilitation at home includes medical advice and physiotherapy treatments for patients who cannot reach the outpatient clinic on their own. The referral is issued by a he alth insurance doctor - a specialist in the field of medical rehabilitation, balneology and physical medicine, rheumatology, neurology, orthopedics and traumatology, or a family doctor. The referral must contain a note that rehabilitation is to take place at the patient's home. When qualifying, the disease and the time elapsed since the onset of the disease are important. The National He alth Fund strictly defines who and how long can use this form of improvement. This group includes patients:
- with focal brain injuries (after cerebral embolism, hemorrhagic stroke, trauma) up to 12 months after the onset;
- with severe damage to the central and peripheral nervous system (the level of damage is determined by the Rankin scale - it describes the degree of disability, experienced ailments anddependence on the environment);
- with spinal cord injury up to one year after the accident;
- chronic patients with progressive disease (myopathy, Parkinson's disease, polymyositis, spinal muscular atrophy, brain tumors, MS, collagenosis, chronic extrapyramidal syndromes, rheumatoid arthritis);
- suffering from degeneration of the hip (or knee) joints after endoprosthesis implantation up to 6 months after surgery;
- after lower limb injuries (up to 6 months after the injury);
- in a vegetative / apalic state.
- After visiting the patient's home, the specialist makes a decision about treatment and sets up a general treatment program. The physiotherapist usually comes three times a week or more often if needed. Using portable devices, he can also perform, for example, electrostimulation or laser therapy. The patient or his guardian confirms the performance of the procedure with his signature. Rehabilitation at home is usually carried out for 4 weeks. The National He alth Fund refunds up to 80 days of therapy per year. For longer rehabilitation you must have a written consent from the head of the NHF branch. The physician who submits such a request on behalf of the patient must justify it accordingly. During rehabilitation classes at home, the patient and his / her caregiver learn how to properly perform the exercises so that they can continue to improve themselves.