Study On Hospital-Cummunity-Family Three-Dimensional Rehabilitation Mode Of Cerebral Palsy

[Objective]To study the changes of gross motor function in the patients with cerebral palsy (Cerebral Palsy, CP) and to analyze the economic burden of rehabilitation treatment under different rehabilitation models.[Methods]Between January 2013 and September 2014,177 cases of children with cerebral palsy in First People’s Hospital of Yancheng and Rehabilitation Hospital with Universal Fraternity of Yancheng were studied. In accordance with the wishes of the parents, the children with cerebral palsy were divided into four groups:hospital-community-family rehabilitation group (n=60), hospital-community rehabilitation group (n=40), hospital rehabilitation group (n=40) and group without control (n=37). The gross motor function of all patients were evaluated by using Gross Motor function measure-88(GMFM-88) scale at the admission, the end of 1st month,3rd month and the 6th month respectively and were evaluated by using cost measure scale at the 6th month.[Results]There were no significant differences in the gross motor function among four groups at the admission. After 6 months, gross motor function of the children in hospital-community-family rehabilitation group, hospital-community rehabilitation group and hospital rehabilitation group of were significantly improved. Comparing with the nonintervention group, the GMFM of each the other three group in percentage of the total score, month score and relative month score were significantly increased (p<0.01). Further analysis found that, compared with the nonintervention group, GMFM of hospital-Community-family rehabilitation group in total percentage was significantly increased (p<0.01) after 3 and 6 months and after 1month、3months and 6 months, the month and month relative percentage of GMFM were significantly increased (p<0.01). The gross motor functions of nonintervention group were only a little improvement. The difference was no statistically significance (p>0.05). Analyzing and comparing from 6 months to 2 years,2-4 years old,4-6 years old,6-12 years old piecewise, the results show that compared with the nonintervention control group, all ages GMFM of the hospital-community-family rehabilitation group in monthly percentage were improved significantly (p<0.05). The younger the age, the more obvious the GMFM score increased. Analysis and comparison of the cost effectiveness of the hospital-community-family rehabilitation group, the hospital-community rehabilitation group, and the hospital rehabilitation group, the results show that the differences between the groups were statistically significant (p<0.01). Every score improved in the gross motor function was cost 206.99 Yuan in hospital-community-family rehabilitation group,282.66 Yuan in hospital-community rehabilitation group and 757.05 Yuan in hospital rehabilitation group. The cost of treatment to the children of hospital-community-family rehabilitation group was significantly lower than the other two treatment groups (p<0.05).[Conclusion]The rehabilitation of cerebral palsy in children is a long-term process. The children with cerebral palsy should be given active rehabilitation treatment. The earlier intervention, the better rehabilitation. The rehabilitation mode of hospital-community-family rehabilitation can significantly promote the improvement of the gross motor function of children, which is suitable for the long-term rehabilitation of children with cerebral palsy, and can greatly reduce the cost of treatment. The hospital-community-family three-dimensional rehabilitation model is more adapt to national situation of our country.