An Integrated Rehabilitation Model: An Ideal Framework for Limiting Health Care Costs


The financial crisis has caused a severe limitation of resources for the public health service and rehabilitation. The proposal of integrated diagnosis and treatment in rehabilitation, involving the introduction of new therapeutic models alongside orthodox models, could lead to a reduction in health care costs through better patient compliance. In rehabilitative assistance in health care, the limiting of financial resources can be simplified, given its multifaceted nature and the need to integrate clinical experience with research. In addition, the phases of rehabilitative recovery do not focus on organ damage, but improved participation and the reduction of disability. For this reason, we have considered incorporating narrative based medicine (NBM) and Psycho-Neuro-Immuno-Endocrinology (PNEI) in the rehabilitation process through an empathetic approach, taking evidence based medicine (EBM) into account, thus creating a “framework” of reference. Managing patients through this “framework” would be a move towards an integrated model of care that could lead to a reduction in health care costs, given the aging population and the rise in patients with chronic pain. The decision to modify health care in rehabilitative assistance through a new “framework” will require time, organizational capacity and experimentation, but may represent the appropriate response for an improved quality of life for patients and a better allocation of resources.

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Collebrusco, L. (2015) An Integrated Rehabilitation Model: An Ideal Framework for Limiting Health Care Costs. Open Journal of Therapy and Rehabilitation, 3, 9-13. doi: 10.4236/ojtr.2015.31002.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Christensen, A.J. (2004) Patient Adherence to Medical Treatment Regimens. Yale University Press, London.
[2] Maher, C.G., Moseley, A.M., et al. (2008) A Description of the Trials, Reviews, and Practice Guide-Lines Indexed in the PEDro Database. Physical Therapy, 88, 1068-1077.
[3] Herbert, R.D., Maher, C.G., et al. (2001) Effective Physiotherapy. BMJ, 323, 788-790.
[4] Sackett, D., Strauss, S., et al. (2000) Evidence Based Medicine—How to Practice and Teach EBM. 2nd Edition, Churchill Livingstone, London, 5-7.
[5] Dawes, M., et al. (2005) Sicily Statement on Evidence-Based Practice. BMC Medical Education, 5, 1.
[6] Ginestra, A., Venere, A. and Vignera, R. (2008) Elementi di comunicazione per le professioni sanitarie. Franco Angeli, Milano.
[7] Decety, J. and Lamm, C. (2006) Human Empathy through the Lens of Social Neuroscience. Scientific World Journal, 6, 1146-1163.
[8] Greenhalgh, T. (1999) Narrative Based Medicine: Narrative Based Medicine in an Evidence Based World. BMJ, 318, 323-325.
[9] Charon, R. (2001) Narrative Medicine: A Model for Empathy, Reflection, Profession and Trust. The Journal of the American Medical Association, 286, 1897-1902.
[10] Silva, S.A., Charon, R. and Wyer, P.C. (2011) The Marriage of Evidence and Narrative: Scientific Nurturance within Clinical Practice. Journal of Evaluation in Clinical Practice, 17, 585-593.
[11] Charon, R. and Wyer, P. (2008) Narrative Evidence Based Medicine. The Lancet, 371, 296-297.
[12] Charon, R. (2001) Narrative Medicine: Form, Function, and Ethics. Annals of Internal Medicine, 134, 83-87.
[13] Besedovsky, H. and Sorkin, E. (1977) Network of Immune-Neuroendocrine Interactions. Clinical Experimental Immunology, 27, 1-12.
[14] Weigent, D.A. and Blalock, J.E. (1987) Interactions between the Neuroendocrine and Immune Systems: Common Hormones and Receptors. Immunological Reviews, 100, 79-108.
[15] Dantzer, R. (2005) Somatization: A Psychoneuroimmune Perspective. Psychoneuroendocrinology, 30, 947-952.
[16] Hojat, M., Gonnella, J.S., Mangione, S., Nasca, T.J., Veloski, J.J., Erdmann, J., Callahan, C.A. and Magee, M. (2002) Physician Empathy: Definition, Components, Measurement, and Relationship to Gender and Specialty. American Journal of Psychiatry, 159, 1563-1569.
[17] Libba, R.M. (2007) Empathy and Empathic Communication: Nursing Student Perceptions of Program Effectiveness, Academic Experiences, and Competence. Dissertation, Auburn University, School of Nursing, Auburn.
[18] Muir Graj, J.A. (1997) Evidence-Based Healthcare. Churchill Livingstone, London.
[19] British Pain Society (2012) Pain in Europe: A Report.
[20] Painful Truth Survey. IML Research.
[21] Galluzi, K. (2005) Management of Neuropathic Pain. Journal of American Osteopathic Association, 105, s12-s19.
[22] Jakab, Z. (2012) Patient Empowerment in the European Region—A Call for Joint Action. Proceedings of the First European Conference on Patient Empowerment, Copenhagen, 11-12 April 2012, 11.
[23] The Lancet (2012) Patient Empowerment—Who Empowers Whom? The Lancet, 380, 650.

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