| Sumario: | Objectives Helse Nord asked the Norwegian Knowledge Centre for the Health Services to summarize the evidence on the most effective organisation of physical medicine and rehabilitation in hospitals. Method This report is an overview over reviews, i.e. we have searched for, critically appraised, and summarised research from existing systematic reviews on the effectiveness of organizing physical medicine and rehabilitation in hospitals. Results We included thirty nine systematic reviews reporting results for six different groups of inpatients. Fifteen of these reviews were on the organisation of treatment and rehabilitation of patients with stroke. There is strong evidence that stroke patients who receive organised inpatient care in a stroke unit are more likely to be alive, independent and living at home one year after the stroke compared with patients who get other kinds of treatment and rehabilitation. For stroke patients in hospitals, "early supported discharge" (ESD) that provides early assessment in hospital, coordinated discharge arrangements and post discharge support can accelerate their discharge home, and increase their chance of being independent. Evaluation and management in geriatric departments of elderly patients admitted to hospitals due to chronic or acute functional failure show a positive effect on survival and return to home compared to ordinary care; i.e. in a medical department. The latest systematic review on elderly patients with hip fracture shows that patients who received multi-disciplinary rehabilitation were at lower risk of dying or being admitted to a nursing home, compared to those who received usual orthopaedic care. Rehabilitation program for patients with MS do not change the level of impairment, but can improve their experience of activity and participation in daily activities. Functional gains are associated with increased intensity of the rehabilitation program for patients with acquired brain injury (ABI), especially to patients with moderate to severe ABI. The only systematic review we found on the effectiveness on spinal injury units (SIU) concluded that patients undergoing immediate referral to SIU's may experience better outcome that patients whose referral is delayed or who are treated else-where. Conclusion With the exception of studies on rehabilitation of stroke patients and elderly patients admitted to hospitals with chronic or acute illnesses, only limited evidence is found to support one way of organizing rehabilitation services in hospitals compared to others. Further research is needed.
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