Rehabilitating the severely disabled: the foreign experience. 1979

J H Noble

This paper sets forth a model for examining the relationships between fourteen policy and politicoeconomic variables, and the social benefits and costs of rehabilitation. Based on discussions in early 1977 with scholars, ministry officials, trade unionists, and politicians in several northwestern European countries, as well as on documentation relating to the rapid growth of disability expenditures and the factors thought to influence it, some "lessons" are presented for policymakers in the United States and other countries. In general, current trends are seen as depressing the post-service earnings of individual rehabilitants, limiting the stabilizing effects of rehabilitation on labor market turnover, and increasing available time for unpaid work in the home and elsewhere. Unequal intergovernmental cost sharing in the provision of benefits and services, it is argued, seems likely to promote inefficient allocation of scarce rehabilitation resources with negative consequences for goal attainment. The high rates of inflation which prevail in the United States and in many northwestern European countries are causing the immediate costs of providing rehabilitation services to rise and simultaneously increasing the opportunity costs of spending for rehabilitation. The net effect of these cost increases is a reduction in the overall benefit/cost ratio that results from investments in rehabilitation. A number of predictions are made about how the United States will shape its disability and rehabilitation policies in the course of the next twenty years.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011153 Population The total number of individuals inhabiting a particular region or area. School Age Population,School-Age Population,Population, School Age,Population, School-Age,Populations,Populations, School Age,Populations, School-Age,School Age Populations,School-Age Populations
D011640 Public Policy A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. Social Policy,Affirmative Action,Migration Policy,Population Policy,Social Protection,Action, Affirmative,Migration Policies,Policies, Migration,Policies, Population,Policies, Public,Policies, Social,Policy, Migration,Policy, Population,Policy, Public,Policy, Social,Population Policies,Protection, Social,Public Policies,Social Policies
D012046 Rehabilitation Restoration of human functions to the maximum degree possible in a person or persons suffering from disease or injury. Habilitation
D012050 Rehabilitation, Vocational Training of the mentally or physically disabled in work skills so they may be returned to regular employment utilizing these skills. Vocational Rehabilitation,Rehabilitations, Vocational,Vocational Rehabilitations
D003362 Cost-Benefit Analysis A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. In contrast a cost effectiveness in general compares cost with qualitative outcomes. Cost and Benefit,Cost-Benefit Data,Benefits and Costs,Cost Benefit,Cost Benefit Analysis,Cost-Utility Analysis,Costs and Benefits,Economic Evaluation,Marginal Analysis,Analyses, Cost Benefit,Analysis, Cost Benefit,Analysis, Cost-Benefit,Analysis, Cost-Utility,Analysis, Marginal,Benefit and Cost,Cost Benefit Analyses,Cost Benefit Data,Cost Utility Analysis,Cost-Benefit Analyses,Cost-Utility Analyses,Data, Cost-Benefit,Economic Evaluations,Evaluation, Economic,Marginal Analyses
D004185 Disability Evaluation Determination of the degree of a physical, mental, or emotional handicap. The diagnosis is applied to legal qualification for benefits and income under disability insurance and to eligibility for Social Security and workmen's compensation benefits. Disability Evaluations,Evaluation, Disability,Evaluations, Disability
D004651 Employment The state of being engaged in an activity or service for wages or salary. Employment Termination,Employment Status,Labor Force,Occupational Status,Status, Occupational,Underemployment,Labor Forces,Status, Employment,Termination, Employment
D005060 Europe The continent north of AFRICA, west of ASIA and east of the ATLANTIC OCEAN. Northern Europe,Southern Europe,Western Europe

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