Ecological aspects concerning the rehabilitation of handicapped persons

When drawing up demand-oriented plans and establishing a network of rehabilitation facilities covering all areas, it is advisable to make an ecological analysis of the area to be served. Such an analysis should take into account the natural physical and socio-geographical conditions as well as basic data relating to the population living in a particular area and its movement. A further step is the topographical determination of available data on chronic diseases and handicaps in the individual discernable areas; besides the various statistical data, one should investigate also the degree of severity and the care required by the individual forms of diseases or handicaps. These factors largely influence the needs in the fields of medical, educational, vocational and social rehabilitation for in-patient or out-patient facilities and the personnel requirements in the form of specialist staff. When performing such calculations, it is often necessary to find a compromise between the various alternatives in accordance with the corresponding, existing socio-political and national health system. On the basis of such data, it is possible to formulate a concrete single plan together with already functioning institutions; such a plan could take its lead from a model concept. Of assistance, in this case, would be an epidemiological assessment which , in a longitudinal section of time, can transform itself into interventionist research and improvement of the deficiencies thereby ascertained. Consideration should also be paid to allowing future actions to be accompanied by scientific measures.