Research proposals for ensuring efficiency in rehabilitation -: What has been done and what is required?

In view of the fact that the resources currently available in the health care system are limited and these are likely to decline still further in future, there will be increasing pressure on the various services within the system to legitimate their value, i.e. their effectiveness and efficiency. This pressure will be particularly felt by the clinical rehabilitation system. The following article provides an overview of the present status of research and a brief outline of the research which will be required in future for ensuring the effectiveness and efficiency within the rehabilitation sector. After a review of several representative studies of the rehabilitation services which illustrate the broad spectrum of the research being conducted in this area in terms of the study designs, the various health care models employed and the different methods of operationalisation of effectiveness, the article focuses on various aspects which can be seen as ,,milestones" on the road to achieving greater ,,professionalism" within the rehabilitation system: the external quality assurance programs of the rehabilitation providers, the inception of ,,rehabilitation sciences" as a research focus to be promoted and the systematic development of guidelines for the main therapeutic indications encountered within the rehabilitation sector. Demonstrated on this basis are the still outstanding requirements needed to ensure further development of effectiveness and efficiency in the rehabilitation system in future. In this context the three central aspects of ,,rehabilitation research",,external quality assurance programs" and ,,guideline development" are discussed.