An update on the access to inpatient rehabilitation facilities across Tunisia in 2023

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Rihab Moncer
Ines Loubiri
Sarra Melki
Sinene Frigui
Walid Ouannes
Ahmed Ben Abdelaziz
Sonia Jemni

Abstract

Introduction: Considering the growing global need and the complexity of health conditions, an intensive rehabilitation in inpatient departments is fundamental. Yet, in Tunisia, the distribution of Inpatient Rehabilitation Facilities is not illustrated.


Aim: To perform an update concerning the rehabilitation’s beds-ratio /1000 Tunisian-inhabitants in 2023.


Methods: Data were collected from the Tunisian Ministry of Health, the Eastern Mediterranean Regional Office, and the National Institute of Statistics websites.


Results: The findings revealed a total number of rehabilitations’ beds 132 among a total of 20000 hospital beds with a rehabilitations’ beds-ratio equal to 0.01/1000 inhabitants. Only three Inpatient Rehabilitation Facilities were identified in Tunisia covering the Greater Tunis, North East, and Center east districts. There was inequity of distribution since the beds ratio is 1.07/1000 in the North east, 0.02/1000 in the Greater Tunis and 0 in the North West and the South of Tunisia.


Conclusion: This update highlighted the alarmingly low rehabilitation’s beds-ratio in Tunisia, coupled to a significant regional disparity. Increasing beds in the existing Inpatient Rehabilitation Facilities and extending outpatient rehabilitation departments with inpatient units might be considered urgent solutions.

Keywords:

Extended care facilities, Health equity , physical and rehabilitation medicine

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References

  1. Nas K, Yazmalar L, Şah V, et al. Rehabilitation of spinal cord injuries. World J Orthop 2015; 6: 8–16.
  2. Forrest G, Reppel A, Kodsi M, et al. Inpatient rehabilitation facilities. Medicine (Baltimore) 2019; 98: e17096.
  3. Watanabe TK, Esquenazi A, Flanagan S. The transformation of the rehabilitation paradigm across the continuum of care. PM R 2018; 10: S264–S271.
  4. Maaoui R, Karoui S, Hfaidh M et al. Cerabral palsy of the child in rehabilitation environment: Epidemiological and clinical profile and therapeutic modalities. Tunis Med 2023; 101 (7): 642-647
  5. Chang AY, Skirbekk VF, Tyrovolas S, et al. Measuring population ageing: an analysis of the Global Burden of Disease Study 2017. The Lancet 2019; 4: e159–e167.
  6. Haagsma JA, Graetz N, Bolliger I, et al. The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013. InjPrev 2016; 22: 3–18.
  7. Cieza A, Causey K, Kamenov K, et al. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396: 2006–2017.
  8. Sohn D-G, Yoon J, Ro J-S, et al. Geographic distribution of central nervous system rehabilitation treatment in Korea and its associated factors. J Korean Med Sci 2023; 38: e147.
  9. Landry MD, Passalent LA, Cott CA. Availability and structure of ambulatory rehabilitation services: a survey of hospitals with designated rehabilitation beds in ontario, Canada. Physiother Can 2008; 60: 246–254.
  10. Health at a Glance: Europe 2020. Available via this URL: https://health.ec.europa.eu/state-health-eu/health-glance-europe/health-glance-europe-2020_en (Last access: November 12, 2023).
  11. Jing Q, Tang Q, Sun M, et al. Regional Disparities of Rehabilitation Resources for Persons with Disabilities in China: Data from 2014 to 2019. Int J Environ Res Public Health 2020; 17: 7319.
  12. Carte sanitaire - Ministère de la santé publique. Available this URL: http://www.health.gov.tn/fr/carte-sanitaire/carte-sanitaire-2011 (Last access: November 12, 2023).
  13. Ravaghi H, Alidoost S, Mannion R, et al. Models and methods for determining the optimal number of beds in hospitals and regions: a systematic scoping review. BMC Health Serv Res 20, 186 (2020).
  14. Code des collectivités locales. Available via this URL : http://www.collectiviteslocales.gov.tn/fr/search/district de la tunisie/ (last access: November 12, 2023).
  15. Statistiques | INS. Available via this URL: https://www.ins.tn/statistiques/111 (Last access: November 12, 2023).
  16. WHO EMRO. Data and statistics. Available via this URL: https://www.emro.who.int/entity/statistics/statistics.html (last access: November 23, 2023).
  17. World Health Organization. Regional Office for the Eastern Mediterranean. Progress on the health-related Sustainable Development Goals and targets in the Eastern Mediterranean Region, 2020. Available via this URL: https://apps.who.int/iris/handle/10665/361800 (Last access: November 12, 2023)
  18. World Health Organization. Regional Office for the Eastern Mediterranean. Vision 2023 Eastern Mediterranean Region : health for all by all : a call for solidarity and action. Available via this URL: https://apps.who.int/iris/handle/10665/326911 (Last access: November 12, 2023).
  19. Rehabilitation 2030: A call for action. Available via this URL: https://www.who.int/publications/m/item/rehabilitation-2030-a-call-for-action (Last access: November 12, 2023).
  20. World Health Organization. The need to scale up rehabilitation. Available via this URL: https://apps.who.int/iris/handle/10665/331210 (Last access: November 12, 2023).
  21. Dee M, Lennon O, O’Sullivan C. A systematic review of physical rehabilitation interventions for stroke in low and lower-middle income countries. DisabilRehabil 2020; 42: 473–501.
  22. Oldridge NB, Pakosh MT, Thomas RJ. Cardiac rehabilitation in low- and middle-income countries: a review on cost and cost-effectiveness. Int Health 2016; 8: 77–82.
  23. Benzarti W, Toulgui E, Ghram A, et al. Impact of a pulmonary rehabilitation program on social disadvantage and physical activity data of postCOVID19 patients: A North-African pilot study. F1000Res 2022; 11: 1226.
  24. Toulgui E, Benzarti W, Rahmani C, et al. Impact of cardiorespiratory rehabilitation program on submaximal exercise capacity of Tunisian male patients with post-COVID19: A pilot study. Front Physiol 2022; 13: 1029766.
  25. Healthcare resource statistics – beds. Available via this URL: https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Healthcare_resource_statistics_-_beds (Last access: November 12, 2023).
  26. Geberemichael SG, Tannor AY, Asegahegn TB, et al. Rehabilitation in Africa. Phys Med Rehabil Clin N Am2019; 30: 757–768.
  27. World HealthOrganization. Regional Office for the Eastern Mediterranean. Strategic action framework to improve access to assistive technology in the Eastern Mediterranean Region. World HealthOrganization. Regional Office for the Eastern Mediterranean. Available via this URL: https://apps.who.int/iris/handle/10665/352488 (Last access: November 12, 2023).
  28. Leochico CFD, Mojica JAP, Rey-Matias RR, et al. Role of telerehabilitation in the rehabilitation medicine training program of a COVID-19 referral center in a developing country. Am J Phys Med Rehabil 2021; 100: 526.