Lancet: more than 2.41 billion people around the world benefit from rehabilitation, and rehabilitation medicine is accelerating from behind the scenes to the front

Recently, the Lancet published the first global disease burden study (GBD) on rehabilitation, which estimates that up to one third of the world's people (2.41 billion people) may benefit from rehabilitation treatment during illness or injury. The growth of these demands is mainly the result of population growth and aging, but the prevalence of some health problems has also increased.

This is the first study on the global disease burden of rehabilitation. It is estimated that up to one third of the world's people (2.41 billion people) may benefit from rehabilitation treatment during illness or injury, including physical therapy, occupational therapy, speech therapy and other rehabilitation medical therapies. This includes 568 million people with low back pain, 732 million people with hearing and visual impairment, and 1 billion people who have experienced fractures, amputations, spinal cord injuries, craniocerebral injuries or other injuries.

When selecting the health issues to be included in the study, the researchers included all diseases that may benefit from rehabilitation at any time during the disease process.

Overall, the researchers found that the number of people with one or more diseases who have benefited from rehabilitation treatment has increased 63% globally since 1990, from 1.48 billion to 2.41 billion. For health problems such as low back pain, the increase in rehabilitation treatment is due to the growth of the global population and the prolongation of people's life expectancy, rather than the rising prevalence of health problems, the researchers said.

The study also provides detailed information on specific regions and countries, describing the disease areas that contribute the most to rehabilitation needs. In terms of population, the country with the largest demand for rehabilitation is China (460 million), followed by India (411 million), followed by the United States (149 million), Indonesia (76 million) and Brazil (70 million).

Skeletal muscle disease is the health problem with the largest demand for rehabilitation services in the world, affecting 1.71 billion people and causing about 149 million years of disability life loss. Among them, the disease burden of low back pain is the heaviest, which is the most common health problem in 160 of 204 countries, affecting 568 million people worldwide and resulting in 64 million years of disability life loss.

A large part of the overall rehabilitation needs can be attributed to another set of health problems - injuries. The study estimated that nearly 1 billion people's lives were affected by fractures, amputations, spinal cord injuries, craniocerebral injuries or other injuries. Among them, fractures have the greatest rehabilitation needs, affecting 436 million people.

Dr Somnath chatterji from the World Health Organization, one of the authors of this study, said: "rehabilitation services are usually regarded as a backup strategy after the failure of prevention or treatment interventions, or a special disability service only needed by minorities“

The results of this study overturn this idea because we found that one third of the world's population needs rehabilitation treatment in the process of injury or illness. More and more people can benefit from rehabilitation treatment. Nowadays, people's life expectancy is longer and longer, but it often coexists with disability and dysfunction. Rehabilitation can effectively improve their physical condition and quality of life.

Rehabilitation services need urgent attention from the government and society, so as to give people the greatest opportunity to live a healthy life.

Rehabilitation services have proven cost-effective, and studies have shown that they can provide successful care models for a variety of health problems in low-income and low - and middle-income countries. However, many countries do not pay enough attention to rehabilitation and often have insufficient resources.

Bringing these rehabilitation services into the community, for example, in conjunction with primary health care, may be a cost-effective way to expand the scope of service delivery to cover all those in need.

Integrating rehabilitation training into the training and qualification evaluation of general practitioners may be one of the ways to help achieve this goal; Education and empowerment of health workers can also be an integral part of the process. "

According to the survey, the market scale of rehabilitation medicine will exceed 200 billion yuan by 2025

As an important part of medical services, rehabilitation medicine is encouraged by national policies and supported by finance; On the other hand, with the development of medical and health undertakings and the improvement of people's living standards, the market demand of the rehabilitation medical industry also drives the rapid development of the industry.

In 2018, the number of rehabilitation medical institutions in China reached 637, of which non-public rehabilitation medical institutions accounted for more than 70%; In 2019, the market scale of China's rehabilitation medical industry was about 70.5 billion yuan; KPMG predicts that from 2020 to 2025, the annual compound growth rate of the market scale of China's rehabilitation medical industry will reach 20.9%. By 2025, the market scale will exceed 200 billion yuan.

1. The number of outpatients in rehabilitation hospital exceeded 10 million

With the development of medical and health undertakings and the improvement of people's living standards, the market demand of rehabilitation medical industry is increasing year by year. Data show that from 2010 to 2018, the number of outpatients in rehabilitation hospitals in China increased from 5.326 million to 10.267 million, with an average annual compound growth rate of 8.5%. In 2018, the number of outpatients exceeded 10 million for the first time.

2. Non public rehabilitation medical institutions account for more than 70%

Driven by the guidance and encouragement of policies and the growth of people's health needs, the number of rehabilitation medical institutions in China has also increased simultaneously. In 2018, the number of rehabilitation medical institutions nationwide reached 637, an increase of 85 compared with 2017.

The number of rehabilitation institutions in China was 4368%, accounting for 434% of the total number of cities in 2018; The number of rural rehabilitation medical institutions is 20, accounting for about 32%.

According to the type of registration, at present, China is dominated by non-public rehabilitation medical institutions. In 2018, the number of non-public rehabilitation medical institutions reached 485, accounting for 76% of the total number of institutions

3. In 2025, the scale of rehabilitation medical market will exceed 200 billion yuan

Since 2015, the market scale of China's rehabilitation medical industry has increased significantly. According to KPMG's calculation, the market scale of China's rehabilitation medical industry in 2019 is about 70.5 billion yuan. It is predicted that from 2020 to 2025, the compound annual growth rate of the market scale of China's rehabilitation medical industry will reach 20.9%. By 2025, the market scale will exceed 200 billion yuan.

Rehabilitation medicine is accelerating from behind the scenes to the front

Rehabilitation not only has a considerable market development scale and prospects, but also the attention of the government and society has accelerated the rehabilitation medical industry from behind the scenes to the front, which is recognized and accepted by more and more people.

The outline of healthy China 2030 plan points out that prevention and rehabilitation should be combined to realize "health management of chronic diseases in the whole population and life cycle". In addition, the outline also expressed concern about mental health and the health of persons with disabilities, and pointed out that rehabilitation services should be provided for patients with mental illness and persons with disabilities through the strategies of "promoting community rehabilitation services for mental disorders" and "precision rehabilitation" respectively.

In recent years, there are many key points closely related to rehabilitation medicine in the new medical reform plan, such as emphasizing the simultaneous development of prevention, treatment and rehabilitation, and confirming the status of rehabilitation medicine; Confirm the separation of medicine and rehabilitation medicine, as a project characterized by medical skill services, its economic value will also be highlighted.

Professor Wan Chunxiao, Department of rehabilitation medicine, General Hospital of Tianjin Medical University, introduced that with the concern of the State Council, more than 20 rehabilitation medical projects have been included in the scope of medical insurance settlement, which has greatly promoted the development of rehabilitation medical work in various places and will also benefit tens of millions of disabled and dysfunctional patients.

Opportunities and challenges coexist, which is also true for the development of rehabilitation medical industry. The development of China's rehabilitation industry still faces four major challenges:

First, people's awareness of rehabilitation medicine is relatively weak, and their understanding of the concept and importance of rehabilitation is too shallow, which means that it is necessary to strengthen the universality of rehabilitation medicine publicity.

Second, the importance of the hospital to the rehabilitation department needs to be improved. The development of the rehabilitation medicine department in each hospital still needs time, and the total proportion in the hospital is difficult to perform well in the short term.

Third, there is a relative shortage of rehabilitation service institutions. Rehabilitation medical services will be mainly undertaken by grass-roots medical institutions. However, there is a huge gap in software and hardware in China's grass-roots medical institutions. The existing grass-roots medical institutions can not meet the needs of rehabilitation treatment in structure.

Fourth, the service content is simple, the investment is insufficient and the equipment is backward. There is still a long way to go in the exploration of applicable diseases, the refinement of treatment methods and the introduction of high-precision instruments.

Source: lancet, prospective economist, China Youth Daily