gms | German Medical Science

Background: The Social Insurance Institution of Finland (Kela) provides intensive medical rehabilitation, such as therapies for persons with severe disabilities. In 2016, the Act on Rehabilitation Benefits was amended, which changed the eligibility criteria for intensive medical rehabilitation. According to the new criteria, a person is entitled to claim intensive medical rehabilitation if she or he (1) is under 65 years of age and (2) has a diagnosed illness or impairment that causes significant difficulty with managing and participating in daily activities. The ICF framework is used to assess the applicant’s functioning. The general aim of the amended Act was to ensure a timely rehabilitation process and to allow a wider group of rehabilitees to seek intensive medical rehabilitation regardless of their disability status.

Aim: The aim of this register-based study is to evaluate the effects of the amended Rehabilitation Benefits Act and the new ICF-based eligibility criteria on Kela’s rehabilitation decisions.

Method: The data covers 42,468 persons who applied for medical rehabilitation from Kela during 2014, 2016 or 2017. The study excludes the year 2015, since the rehabilitation decisions issued then anticipated the forthcoming legislation. The data includes sociodemographic information and information on health status, type of service and rehabilitation decisions.

Results/findings: Eligibility criteria based on the ICF framework increased the number of applicants. The proportional share of children and youths diagnosed with mental and behavioural disorders (F00–F99) increased among those who were granted intensive medical rehabilitation. Speech therapy, psychotherapy and occupational therapy increased among favorable decisions.

Discussion and conclusions: Findings of this study indicate that ICF-based eligibility criteria allocate rehabilitation services adequately.