Mapping rehabilitation resources for able-bodied polytrauma patients in Sweden
Ragnar Ang, Cecilia Engströmi Mattisson, Åsa Lundgren-Nilsson, Dominika HögbergAbstract
Introduction
The Swedish trauma care system was revised in 2014. This project audited the prehospital and intrahospital care, and aimed to improve the overall trauma care system. However, rehabilitation after trauma was not included in this project. As Swedish trauma care subsequently developed over the past decade into regional trauma systems, the aftercare of severely injured patients has not kept up with this development. This study aimed to observe and quantify the rehabilitation resources for patients in working age within the regions, but also nation wide.
Methods
All trauma hospitals in Sweden who report to the Swedish trauma registry were included in this review. Representatives of each hospital were asked to respond to a survey where the availability of existing rehabilitation resources was requested. The survey design is based on international guidelines from WHO, as well as the Norwegian trauma guidelines.
Results
A difference in resources throughout the country was reported, with the underlying notion of underwhelming availability for inpatient rehabilitation (71% reported zero beds for specialised rehabilitation care). Also on surgical wards, staff was rarely (24%) trained appropriately for rehabilitation. The responders were overall negative on the ability to provide multidisciplinary rehabilitation after the initial somatic needs were finalised (−56 Net Promotor Score). 7% Reported the presence of a step-down unit solely for the purpose of early rehabilitation.
Discussion
In conclusion, the rehabilitation process after polytrauma appears to be in need of systematic audit and improvement in order to meet the growing demands of the contemporary and future trauma population in Sweden.