Factors associated with the use of rehabilitation services among people with disabilities in Chile: A population-based study

Factors associated with the use of rehabilitation... | F1000Research "use strict";function _typeof(t){return(_typeof="function"==typeof Symbol&&"symbol"==typeof Symbol.iterator?function(t){return typeof t}:function(t){return t&&"function"==typeof Symbol&&t.constructor===Symbol&&t!==Symbol.prototype?"symbol":typeof t})(t)}!function(){var t=function(){var t,e,o=[],n=window,r=n;for(;r;){try{if(r.frames.__tcfapiLocator){t=r;break}}catch(t){}if(r===n.top)break;r=r.parent}t||(!function t(){var e=n.document,o=!!n.frames.__tcfapiLocator;if(!o)if(e.body){var r=e.createElement("iframe");r.style.cssText="display:none",r.name="__tcfapiLocator",e.body.appendChild(r)}else setTimeout(t,5);return!o}(),n.__tcfapi=function(){for(var t=arguments.length,n=new Array(t),r=0;r 3&&2===parseInt(n[1],10)&&"boolean"==typeof n[3]&&(e=n[3],"function"==typeof n[2]&&n[2]("set",!0)):"ping"===n[0]?"function"==typeof n[2]&&n[2]({gdprApplies:e,cmpLoaded:!1,cmpStatus:"stub"}):o.push(n)},n.addEventListener("message",(function(t){var e="string"==typeof t.data,o={};if(e)try{o=JSON.parse(t.data)}catch(t){}else o=t.data;var n="object"===_typeof(o)&&null!==o?o.__tcfapiCall:null;n&&window.__tcfapi(n.command,n.version,(function(o,r){var a={__tcfapiReturn:{returnValue:o,success:r,callId:n.callId}};t&&t.source&&t.source.postMessage&&t.source.postMessage(e?JSON.stringify(a):a,"*")}),n.parameter)}),!1))};"undefined"!=typeof module?module.exports=t:t()}(); dataLayer = dataLayer || []; // Standard GTM initialization - Google Consent Mode handles consent automatically (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start': new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0], j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src= 'https://www.googletagmanager.com/gtm.js?id='+i+dl+ '>m_auth=hzk0Vc3qFsQYhCrIoHz68A>m_preview=env-1>m_cookies_win=x';f.parentNode.insertBefore(j,f); })(window,document,'script','dataLayer','GTM-MWFK8L5J'); ;window.NREUM||(NREUM={});NREUM.init={distributed_tracing:{enabled:true},privacy:{cookies_enabled:true},ajax:{deny_list:["bam.nr-data.net"]}}; ;NREUM.loader_config={accountID:"438030",trustKey:"438030",agentID:"772317073",licenseKey:"97f8f67f26",applicationID:"772317073"} ;NREUM.info={beacon:"bam.nr-data.net",errorBeacon:"bam.nr-data.net",licenseKey:"97f8f67f26",applicationID:"772317073",sa:1} ;/*! For license information please see nr-loader-spa-1.236.0.min.js.LICENSE.txt */ (()=>{"use strict";var e,t,r={5763:(e,t,r)=>{r.d(t,{P_:()=>l,Mt:()=>g,C5:()=>s,DL:()=>v,OP:()=>T,lF:()=>D,Yu:()=>y,Dg:()=>h,CX:()=>c,GE:()=>b,sU:()=>_});var n=r(8632),i=r(9567);const o={beacon:n.ce.beacon,errorBeacon:n.ce.errorBeacon,licenseKey:void 0,applicationID:void 0,sa:void 0,queueTime:void 0,applicationTime:void 0,ttGuid:void 0,user:void 0,account:void 0,product:void 0,extra:void 0,jsAttributes:{},userAttributes:void 0,atts:void 0,transactionName:void 0,tNamePlain:void 0},a={};function s(e){if(!e)throw new Error("All info objects require an agent identifier!");if(!a[e])throw new Error("Info for ".concat(e," was never set"));return a[e]}function c(e,t){if(!e)throw new Error("All info objects require an agent identifier!");a[e]=(0,i.D)(t,o),(0,n.Qy)(e,a[e],"info")}var u=r(7056);const d=()=>{const e={blockSelector:"[data-nr-block]",maskInputOptions:{password:!0}};return{allow_bfcache:!0,privacy:{cookies_enabled:!0},ajax:{deny_list:void 0,enabled:!0,harvestTimeSeconds:10},distributed_tracing:{enabled:void 0,exclude_newrelic_header:void 0,cors_use_newrelic_header:void 0,cors_use_tracecontext_headers:void 0,allowed_origins:void 0},session:{domain:void 0,expiresMs:u.oD,inactiveMs:u.Hb},ssl:void 0,obfuscate:void 0,jserrors:{enabled:!0,harvestTimeSeconds:10},metrics:{enabled:!0},page_action:{enabled:!0,harvestTimeSeconds:30},page_view_event:{enabled:!0},page_view_timing:{enabled:!0,harvestTimeSeconds:30,long_task:!1},session_trace:{enabled:!0,harvestTimeSeconds:10},harvest:{tooManyRequestsDelay:60},session_replay:{enabled:!1,harvestTimeSeconds:60,sampleRate:.1,errorSampleRate:.1,maskTextSelector:"*",maskAllInputs:!0,get blockClass(){return"nr-block"},get ignoreClass(){return"nr-ignore"},get maskTextClass(){return"nr-mask"},get blockSelector(){return e.blockSelector},set blockSelector(t){e.blockSelector+=",".concat(t)},get maskInputOptions(){return e.maskInputOptions},set maskInputOptions(t){e.maskInputOptions={...t,password:!0}}},spa:{enabled:!0,harvestTimeSeconds:10}}},f={};function l(e){if(!e)throw new Error("All configuration objects require an agent identifier!");if(!f[e])throw new Error("Configuration for ".concat(e," was never set"));return f[e]}function h(e,t){if(!e)throw new Error("All configuration objects require an agent identifier!");f[e]=(0,i.D)(t,d()),(0,n.Qy)(e,f[e],"config")}function g(e,t){if(!e)throw new Error("All configuration objects require an agent identifier!");var r=l(e);if(r){for(var n=t.split("."),i=0;i {r.d(t,{D:()=>i});var n=r(50);function i(e,t){try{if(!e||"object"!=typeof e)return(0,n.Z)("Setting a Configurable requires an object as input");if(!t||"object"!=typeof t)return(0,n.Z)("Setting a Configurable requires a model to set its initial properties");const r=Object.create(Object.getPrototypeOf(t),Object.getOwnPropertyDescriptors(t)),o=0===Object.keys(r).length?e:r;for(let a in o)if(void 0!==e[a])try{"object"==typeof e[a]&&"object"==typeof t[a]?r[a]=i(e[a],t[a]):r[a]=e[a]}catch(e){(0,n.Z)("An error occurred while setting a property of a Configurable",e)}return r}catch(e){(0,n.Z)("An error occured while setting a Configurable",e)}}},6818:(e,t,r)=>{r.d(t,{Re:()=>i,gF:()=>o,q4:()=>n});const n="1.236.0",i="PROD",o="CDN"},385:(e,t,r)=>{r.d(t,{FN:()=>a,IF:()=>u,Nk:()=>f,Tt:()=>s,_A:()=>o,il:()=>n,pL:()=>c,v6:()=>i,w1:()=>d});const n="undefined"!=typeof window&&!!window.document,i="undefined"!=typeof WorkerGlobalScope&&("undefined"!=typeof self&&self instanceof WorkerGlobalScope&&self.navigator instanceof WorkerNavigator||"undefined"!=typeof globalThis&&globalThis instanceof WorkerGlobalScope&&globalThis.navigator instanceof WorkerNavigator),o=n?window:"undefined"!=typeof WorkerGlobalScope&&("undefined"!=typeof self&&self instanceof WorkerGlobalScope&&self||"undefined"!=typeof globalThis&&globalThis instanceof WorkerGlobalScope&&globalThis),a=""+o?.location,s=/iPad|iPhone|iPod/.test(navigator.userAgent),c=s&&"undefined"==typeof SharedWorker,u=(()=>{const e=navigator.userAgent.match(/Firefox[/\s](\d+\.\d+)/);return Array.isArray(e)&&e.length>=2?+e[1]:0})(),d=Boolean(n&&window.document.documentMode),f=!!navigator.sendBeacon},1117:(e,t,r)=>{r.d(t,{w:()=>o});var n=r(50);const i={agentIdentifier:"",ee:void 0};class o{constructor(e){try{if("object"!=typeof e)return(0,n.Z)("shared context requires an object as input");this.sharedContext={},Object.assign(this.sharedContext,i),Object.entries(e).forEach((e=>{let[t,r]=e;Object.keys(i).includes(t)&&(this.sharedContext[t]=r)}))}catch(e){(0,n.Z)("An error occured while setting SharedContext",e)}}}},8e3:(e,t,r)=>{r.d(t,{L:()=>d,R:()=>c});var n=r(2177),i=r(1284),o=r(4322),a=r(3325);const s={};function c(e,t){const r={staged:!1,priority:a.p[t]||0};u(e),s[e].get(t)||s[e].set(t,r)}function u(e){e&&(s[e]||(s[e]=new Map))}function d(){let e=arguments.length>0&&void 0!==arguments[0]?arguments[0]:"",t=arguments.length>1&&void 0!==arguments[1]?arguments[1]:"feature";if(u(e),!e||!s[e].get(t))return a(t);s[e].get(t).staged=!0;const r=[...s[e]];function a(t){const r=e?n.ee.get(e):n.ee,a=o.X.handlers;if(r.backlog&&a){var s=r.backlog[t],c=a[t];if(c){for(var u=0;s&&u {let[t,r]=e;return r.staged}))&&(r.sort(((e,t)=>e[1].priority-t[1].priority)),r.forEach((e=>{let[t]=e;a(t)})))}function f(e,t){var r=e[1];(0,i.D)(t[r],(function(t,r){var n=e[0];if(r[0]===n){var i=r[1],o=e[3],a=e[2];i.apply(o,a)}}))}},2177:(e,t,r)=>{r.d(t,{c:()=>f,ee:()=>u});var n=r(8632),i=r(2210),o=r(1284),a=r(5763),s="nr@context";let c=(0,n.fP)();var u;function d(){}function f(e){return(0,i.X)(e,s,l)}function l(){return new d}function h(){u.aborted=!0,u.backlog={}}c.ee?u=c.ee:(u=function e(t,r){var n={},c={},f={},g=!1;try{g=16===r.length&&(0,a.OP)(r).isolatedBacklog}catch(e){}var p={on:b,addEventListener:b,removeEventListener:y,emit:v,get:x,listeners:w,context:m,buffer:A,abort:h,aborted:!1,isBuffering:E,debugId:r,backlog:g?{}:t&&"object"==typeof t.backlog?t.backlog:{}};return p;function m(e){return e&&e instanceof d?e:e?(0,i.X)(e,s,l):l()}function v(e,r,n,i,o){if(!1!==o&&(o=!0),!u.aborted||i){t&&o&&t.emit(e,r,n);for(var a=m(n),s=w(e),d=s.length,f=0;fn,p:()=>i});var n=r(2177).ee.get("handle");function i(e,t,r,i,o){o?(o.buffer([e],i),o.emit(e,t,r)):(n.buffer([e],i),n.emit(e,t,r))}},4322:(e,t,r)=>{r.d(t,{X:()=>o});var n=r(5546);o.on=a;var i=o.handlers={};function o(e,t,r,o){a(o||n.E,i,e,t,r)}function a(e,t,r,i,o){o||(o="feature"),e||(e=n.E);var a=t[o]=t[o]||{};(a[r]=a[r]||[]).push([e,i])}},3239:(e,t,r)=>{r.d(t,{bP:()=>s,iz:()=>c,m$:()=>a});var n=r(385);let i=!1,o=!1;try{const e={get passive(){return i=!0,!1},get signal(){return o=!0,!1}};n._A.addEventListener("test",null,e),n._A.removeEventListener("test",null,e)}catch(e){}function a(e,t){return i||o?{capture:!!e,passive:i,signal:t}:!!e}function s(e,t){let r=arguments.length>2&&void 0!==arguments[2]&&arguments[2],n=arguments.length>3?arguments[3]:void 0;window.addEventListener(e,t,a(r,n))}function c(e,t){let r=arguments.length>2&&void 0!==arguments[2]&&arguments[2],n=arguments.length>3?arguments[3]:void 0;document.addEventListener(e,t,a(r,n))}},4402:(e,t,r)=>{r.d(t,{Ht:()=>u,M:()=>c,Rl:()=>a,ky:()=>s});var n=r(385);const i="xxxxxxxx-xxxx-4xxx-yxxx-xxxxxxxxxxxx";function o(e,t){return e?15&e[t]:16*Math.random()|0}function a(){const e=n._A?.crypto||n._A?.msCrypto;let t,r=0;return e&&e.getRandomValues&&(t=e.getRandomValues(new Uint8Array(31))),i.split("").map((e=>"x"===e?o(t,++r).toString(16):"y"===e?(3&o()|8).toString(16):e)).join("")}function s(e){const t=n._A?.crypto||n._A?.msCrypto;let r,i=0;t&&t.getRandomValues&&(r=t.getRandomValues(new Uint8Array(31)));const a=[];for(var s=0;s {r.d(t,{Bq:()=>n,Hb:()=>o,oD:()=>i});const n="NRBA",i=144e5,o=18e5},7894:(e,t,r)=>{function n(){return Math.round(performance.now())}r.d(t,{z:()=>n})},7243:(e,t,r)=>{r.d(t,{e:()=>o});var n=r(385),i={};function o(e){if(e in i)return i[e];if(0===(e||"").indexOf("data:"))return{protocol:"data"};let t;var r=n._A?.location,o={};if(n.il)t=document.createElement("a"),t.href=e;else try{t=new URL(e,r.href)}catch(e){return o}o.port=t.port;var a=t.href.split("://");!o.port&&a[1]&&(o.port=a[1].split("/")[0].split("@").pop().split(":")[1]),o.port&&"0"!==o.port||(o.port="https"===a[0]?"443":"80"),o.hostname=t.hostname||r.hostname,o.pathname=t.pathname,o.protocol=a[0],"/"!==o.pathname.charAt(0)&&(o.pathname="/"+o.pathname);var s=!t.protocol||":"===t.protocol||t.protocol===r.protocol,c=t.hostname===r.hostname&&t.port===r.port;return o.sameOrigin=s&&(!t.hostname||c),"/"===o.pathname&&(i[e]=o),o}},50:(e,t,r)=>{function n(e,t){"function"==typeof console.warn&&(console.warn("New Relic: ".concat(e)),t&&console.warn(t))}r.d(t,{Z:()=>n})},2587:(e,t,r)=>{r.d(t,{N:()=>c,T:()=>u});var n=r(2177),i=r(5546),o=r(8e3),a=r(3325);const s={stn:[a.D.sessionTrace],err:[a.D.jserrors,a.D.metrics],ins:[a.D.pageAction],spa:[a.D.spa],sr:[a.D.sessionReplay,a.D.sessionTrace]};function c(e,t){const r=n.ee.get(t);e&&"object"==typeof e&&(Object.entries(e).forEach((e=>{let[t,n]=e;void 0===u[t]&&(s[t]?s[t].forEach((e=>{n?(0,i.p)("feat-"+t,[],void 0,e,r):(0,i.p)("block-"+t,[],void 0,e,r),(0,i.p)("rumresp-"+t,[Boolean(n)],void 0,e,r)})):n&&(0,i.p)("feat-"+t,[],void 0,void 0,r),u[t]=Boolean(n))})),Object.keys(s).forEach((e=>{void 0===u[e]&&(s[e]?.forEach((t=>(0,i.p)("rumresp-"+e,[!1],void 0,t,r))),u[e]=!1)})),(0,o.L)(t,a.D.pageViewEvent))}const u={}},2210:(e,t,r)=>{r.d(t,{X:()=>i});var n=Object.prototype.hasOwnProperty;function i(e,t,r){if(n.call(e,t))return e[t];var i=r();if(Object.defineProperty&&Object.keys)try{return Object.defineProperty(e,t,{value:i,writable:!0,enumerable:!1}),i}catch(e){}return e[t]=i,i}},1284:(e,t,r)=>{r.d(t,{D:()=>n});const n=(e,t)=>Object.entries(e||{}).map((e=>{let[r,n]=e;return t(r,n)}))},4351:(e,t,r)=>{r.d(t,{P:()=>o});var n=r(2177);const i=()=>{const e=new WeakSet;return(t,r)=>{if("object"==typeof r&&null!==r){if(e.has(r))return;e.add(r)}return r}};function o(e){try{return JSON.stringify(e,i())}catch(e){try{n.ee.emit("internal-error",[e])}catch(e){}}}},3960:(e,t,r)=>{r.d(t,{K:()=>a,b:()=>o});var n=r(3239);function i(){return"undefined"==typeof document||"complete"===document.readyState}function o(e,t){if(i())return e();(0,n.bP)("load",e,t)}function a(e){if(i())return e();(0,n.iz)("DOMContentLoaded",e)}},8632:(e,t,r)=>{r.d(t,{EZ:()=>u,Qy:()=>c,ce:()=>o,fP:()=>a,gG:()=>d,mF:()=>s});var n=r(7894),i=r(385);const o={beacon:"bam.nr-data.net",errorBeacon:"bam.nr-data.net"};function a(){return i._A.NREUM||(i._A.NREUM={}),void 0===i._A.newrelic&&(i._A.newrelic=i._A.NREUM),i._A.NREUM}function s(){let e=a();return e.o||(e.o={ST:i._A.setTimeout,SI:i._A.setImmediate,CT:i._A.clearTimeout,XHR:i._A.XMLHttpRequest,REQ:i._A.Request,EV:i._A.Event,PR:i._A.Promise,MO:i._A.MutationObserver,FETCH:i._A.fetch}),e}function c(e,t,r){let i=a();const o=i.initializedAgents||{},s=o[e]||{};return Object.keys(s).length||(s.initializedAt={ms:(0,n.z)(),date:new Date}),i.initializedAgents={...o,[e]:{...s,[r]:t}},i}function u(e,t){a()[e]=t}function d(){return function(){let e=a();const t=e.info||{};e.info={beacon:o.beacon,errorBeacon:o.errorBeacon,...t}}(),function(){let e=a();const t=e.init||{};e.init={...t}}(),s(),function(){let e=a();const t=e.loader_config||{};e.loader_config={...t}}(),a()}},7956:(e,t,r)=>{r.d(t,{N:()=>i});var n=r(3239);function i(e){let t=arguments.length>1&&void 0!==arguments[1]&&arguments[1],r=arguments.length>2?arguments[2]:void 0,i=arguments.length>3?arguments[3]:void 0;return void(0,n.iz)("visibilitychange",(function(){if(t)return void("hidden"==document.visibilityState&&e());e(document.visibilityState)}),r,i)}},1214:(e,t,r)=>{r.d(t,{em:()=>v,u5:()=>N,QU:()=>S,_L:()=>I,Gm:()=>L,Lg:()=>M,gy:()=>U,BV:()=>Q,Kf:()=>ee});var n=r(2177);const i="nr@original";var o=Object.prototype.hasOwnProperty,a=!1;function s(e,t){return e||(e=n.ee),r.inPlace=function(e,t,n,i,o){n||(n="");var a,s,c,u="-"===n.charAt(0);for(c=0;c 2?n-2:0),o=2;o {r(A[T],e,w),r(E[T],e,w)})),r(l._A,"fetch",y),t.on(y+"end",(function(e,r){var n=this;if(r){var i=r.headers.get("content-length");null!==i&&(n.rxSize=i),t.emit(y+"done",[null,r],n)}else t.emit(y+"done",[e],n)})),t}const O={},j=["pushState","replaceState"];function S(e){const t=function(e){return(e||n.ee).get("history")}(e);return!l.il||O[t.debugId]++||(O[t.debugId]=1,s(t).inPlace(window.history,j,"-")),t}var P=r(3239);const C={},R=["appendChild","insertBefore","replaceChild"];function I(e){const t=function(e){return(e||n.ee).get("jsonp")}(e);if(!l.il||C[t.debugId])return t;C[t.debugId]=!0;var r=s(t),i=/[?&](?:callback|cb)=([^&#]+)/,o=/(.*)\.([^.]+)/,a=/^(\w+)(\.|$)(.*)$/;function c(e,t){var r=e.match(a),n=r[1],i=r[3];return i?c(i,t[n]):t[n]}return r.inPlace(Node.prototype,R,"dom-"),t.on("dom-start",(function(e){!function(e){if(!e||"string"!=typeof e.nodeName||"script"!==e.nodeName.toLowerCase())return;if("function"!=typeof e.addEventListener)return;var n=(a=e.src,s=a.match(i),s?s[1]:null);var a,s;if(!n)return;var u=function(e){var t=e.match(o);if(t&&t.length>=3)return{key:t[2],parent:c(t[1],window)};return{key:e,parent:window}}(n);if("function"!=typeof u.parent[u.key])return;var d={};function f(){t.emit("jsonp-end",[],d),e.removeEventListener("load",f,(0,P.m$)(!1)),e.removeEventListener("error",l,(0,P.m$)(!1))}function l(){t.emit("jsonp-error",[],d),t.emit("jsonp-end",[],d),e.removeEventListener("load",f,(0,P.m$)(!1)),e.removeEventListener("error",l,(0,P.m$)(!1))}r.inPlace(u.parent,[u.key],"cb-",d),e.addEventListener("load",f,(0,P.m$)(!1)),e.addEventListener("error",l,(0,P.m$)(!1)),t.emit("new-jsonp",[e.src],d)}(e[0])})),t}var k=r(5763);const H={};function L(e){const t=function(e){return(e||n.ee).get("mutation")}(e);if(!l.il||H[t.debugId])return t;H[t.debugId]=!0;var r=s(t),i=k.Yu.MO;return i&&(window.MutationObserver=function(e){return this instanceof i?new i(r(e,"fn-")):i.apply(this,arguments)},MutationObserver.prototype=i.prototype),t}const z={};function M(e){const t=function(e){return(e||n.ee).get("promise")}(e);if(z[t.debugId])return t;z[t.debugId]=!0;var r=n.c,o=s(t),a=k.Yu.PR;return a&&function(){function e(r){var n=t.context(),i=o(r,"executor-",n,null,!1);const s=Reflect.construct(a,[i],e);return t.context(s).getCtx=function(){return n},s}l._A.Promise=e,Object.defineProperty(e,"name",{value:"Promise"}),e.toString=function(){return a.toString()},Object.setPrototypeOf(e,a),["all","race"].forEach((function(r){const n=a[r];e[r]=function(e){let i=!1;[...e||[]].forEach((e=>{this.resolve(e).then(a("all"===r),a(!1))}));const o=n.apply(this,arguments);return o;function a(e){return function(){t.emit("propagate",[null,!i],o,!1,!1),i=i||!e}}}})),["resolve","reject"].forEach((function(r){const n=a[r];e[r]=function(e){const r=n.apply(this,arguments);return e!==r&&t.emit("propagate",[e,!0],r,!1,!1),r}})),e.prototype=a.prototype;const n=a.prototype.then;a.prototype.then=function(){var e=this,i=r(e);i.promise=e;for(var a=arguments.length,s=new Array(a),c=0;c e())),t};function m(e,t){i.inPlace(t,["onreadystatechange"],"fn-",E)}function b(){var e=this,t=r.context(e);e.readyState>3&&!t.resolved&&(t.resolved=!0,r.emit("xhr-resolved",[],e)),i.inPlace(e,f,"fn-",E)}if(function(e,t){for(var r in e)t[r]=e[r]}(o,p),p.prototype=o.prototype,i.inPlace(p.prototype,J,"-xhr-",E),r.on("send-xhr-start",(function(e,t){m(e,t),function(e){h.push(e),a&&(y?y.then(A):u?u(A):(w=-w,x.data=w))}(t)})),r.on("open-xhr-start",m),a){var y=c&&c.resolve();if(!u&&!c){var w=1,x=document.createTextNode(w);new a(A).observe(x,{characterData:!0})}}else t.on("fn-end",(function(e){e[0]&&e[0].type===d||A()}));function A(){for(var e=0;e {r.d(t,{t:()=>n});const n=r(3325).D.ajax},6660:(e,t,r)=>{r.d(t,{A:()=>i,t:()=>n});const n=r(3325).D.jserrors,i="nr@seenError"},3081:(e,t,r)=>{r.d(t,{gF:()=>o,mY:()=>i,t9:()=>n,vz:()=>s,xS:()=>a});const n=r(3325).D.metrics,i="sm",o="cm",a="storeSupportabilityMetrics",s="storeEventMetrics"},4649:(e,t,r)=>{r.d(t,{t:()=>n});const n=r(3325).D.pageAction},7633:(e,t,r)=>{r.d(t,{Dz:()=>i,OJ:()=>a,qw:()=>o,t9:()=>n});const n=r(3325).D.pageViewEvent,i="firstbyte",o="domcontent",a="windowload"},9251:(e,t,r)=>{r.d(t,{t:()=>n});const n=r(3325).D.pageViewTiming},3614:(e,t,r)=>{r.d(t,{BST_RESOURCE:()=>i,END:()=>s,FEATURE_NAME:()=>n,FN_END:()=>u,FN_START:()=>c,PUSH_STATE:()=>d,RESOURCE:()=>o,START:()=>a});const n=r(3325).D.sessionTrace,i="bstResource",o="resource",a="-start",s="-end",c="fn"+a,u="fn"+s,d="pushState"},7836:(e,t,r)=>{r.d(t,{BODY:()=>A,CB_END:()=>E,CB_START:()=>u,END:()=>x,FEATURE_NAME:()=>i,FETCH:()=>_,FETCH_BODY:()=>v,FETCH_DONE:()=>m,FETCH_START:()=>p,FN_END:()=>c,FN_START:()=>s,INTERACTION:()=>l,INTERACTION_API:()=>d,INTERACTION_EVENTS:()=>o,JSONP_END:()=>b,JSONP_NODE:()=>g,JS_TIME:()=>T,MAX_TIMER_BUDGET:()=>a,REMAINING:()=>f,SPA_NODE:()=>h,START:()=>w,originalSetTimeout:()=>y});var n=r(5763);const i=r(3325).D.spa,o=["click","submit","keypress","keydown","keyup","change"],a=999,s="fn-start",c="fn-end",u="cb-start",d="api-ixn-",f="remaining",l="interaction",h="spaNode",g="jsonpNode",p="fetch-start",m="fetch-done",v="fetch-body-",b="jsonp-end",y=n.Yu.ST,w="-start",x="-end",A="-body",E="cb"+x,T="jsTime",_="fetch"},5938:(e,t,r)=>{r.d(t,{W:()=>o});var n=r(5763),i=r(2177);class o{constructor(e,t,r){this.agentIdentifier=e,this.aggregator=t,this.ee=i.ee.get(e,(0,n.OP)(this.agentIdentifier).isolatedBacklog),this.featureName=r,this.blocked=!1}}},9144:(e,t,r)=>{r.d(t,{j:()=>m});var n=r(3325),i=r(5763),o=r(5546),a=r(2177),s=r(7894),c=r(8e3),u=r(3960),d=r(385),f=r(50),l=r(3081),h=r(8632);function g(){const e=(0,h.gG)();["setErrorHandler","finished","addToTrace","inlineHit","addRelease","addPageAction","setCurrentRouteName","setPageViewName","setCustomAttribute","interaction","noticeError","setUserId"].forEach((t=>{e[t]=function(){for(var r=arguments.length,n=new Array(r),i=0;i 1?r-1:0),i=1;i {e.exposed&&e.api[t]&&o.push(e.api[t](...n))})),o.length>1?o:o[0]}(t,...n)}}))}var p=r(2587);function m(e){let t=arguments.length>1&&void 0!==arguments[1]?arguments[1]:{},m=arguments.length>2?arguments[2]:void 0,v=arguments.length>3?arguments[3]:void 0,{init:b,info:y,loader_config:w,runtime:x={loaderType:m},exposed:A=!0}=t;const E=(0,h.gG)();y||(b=E.init,y=E.info,w=E.loader_config),(0,i.Dg)(e,b||{}),(0,i.GE)(e,w||{}),(0,i.sU)(e,x),y.jsAttributes??={},d.v6&&(y.jsAttributes.isWorker=!0),(0,i.CX)(e,y),g();const T=function(e,t){t||(0,c.R)(e,"api");const h={};var g=a.ee.get(e),p=g.get("tracer"),m="api-",v=m+"ixn-";function b(t,r,n,o){const a=(0,i.C5)(e);return null===r?delete a.jsAttributes[t]:(0,i.CX)(e,{...a,jsAttributes:{...a.jsAttributes,[t]:r}}),x(m,n,!0,o||null===r?"session":void 0)(t,r)}function y(){}["setErrorHandler","finished","addToTrace","inlineHit","addRelease"].forEach((e=>h[e]=x(m,e,!0,"api"))),h.addPageAction=x(m,"addPageAction",!0,n.D.pageAction),h.setCurrentRouteName=x(m,"routeName",!0,n.D.spa),h.setPageViewName=function(t,r){if("string"==typeof t)return"/"!==t.charAt(0)&&(t="/"+t),(0,i.OP)(e).customTransaction=(r||"http://custom.transaction")+t,x(m,"setPageViewName",!0)()},h.setCustomAttribute=function(e,t){let r=arguments.length>2&&void 0!==arguments[2]&&arguments[2];if("string"==typeof e){if(["string","number"].includes(typeof t)||null===t)return b(e,t,"setCustomAttribute",r);(0,f.Z)("Failed to execute setCustomAttribute.\nNon-null value must be a string or number type, but a type of was provided."))}else(0,f.Z)("Failed to execute setCustomAttribute.\nName must be a string type, but a type of was provided."))},h.setUserId=function(e){if("string"==typeof e||null===e)return b("enduser.id",e,"setUserId",!0);(0,f.Z)("Failed to execute setUserId.\nNon-null value must be a string type, but a type of was provided."))},h.interaction=function(){return(new y).get()};var w=y.prototype={createTracer:function(e,t){var r={},i=this,a="function"==typeof t;return(0,o.p)(v+"tracer",[(0,s.z)(),e,r],i,n.D.spa,g),function(){if(p.emit((a?"":"no-")+"fn-start",[(0,s.z)(),i,a],r),a)try{return t.apply(this,arguments)}catch(e){throw p.emit("fn-err",[arguments,this,"string"==typeof e?new Error(e):e],r),e}finally{p.emit("fn-end",[(0,s.z)()],r)}}}};function x(e,t,r,i){return function(){return(0,o.p)(l.xS,["API/"+t+"/called"],void 0,n.D.metrics,g),i&&(0,o.p)(e+t,[(0,s.z)(),...arguments],r?null:this,i,g),r?void 0:this}}function A(){r.e(439).then(r.bind(r,7438)).then((t=>{let{setAPI:r}=t;r(e),(0,c.L)(e,"api")})).catch((()=>(0,f.Z)("Downloading runtime APIs failed...")))}return["actionText","setName","setAttribute","save","ignore","onEnd","getContext","end","get"].forEach((e=>{w[e]=x(v,e,void 0,n.D.spa)})),h.noticeError=function(e,t){"string"==typeof e&&(e=new Error(e)),(0,o.p)(l.xS,["API/noticeError/called"],void 0,n.D.metrics,g),(0,o.p)("err",[e,(0,s.z)(),!1,t],void 0,n.D.jserrors,g)},d.il?(0,u.b)((()=>A()),!0):A(),h}(e,v);return(0,h.Qy)(e,T,"api"),(0,h.Qy)(e,A,"exposed"),(0,h.EZ)("activatedFeatures",p.T),T}},3325:(e,t,r)=>{r.d(t,{D:()=>n,p:()=>i});const n={ajax:"ajax",jserrors:"jserrors",metrics:"metrics",pageAction:"page_action",pageViewEvent:"page_view_event",pageViewTiming:"page_view_timing",sessionReplay:"session_replay",sessionTrace:"session_trace",spa:"spa"},i={[n.pageViewEvent]:1,[n.pageViewTiming]:2,[n.metrics]:3,[n.jserrors]:4,[n.ajax]:5,[n.sessionTrace]:6,[n.pageAction]:7,[n.spa]:8,[n.sessionReplay]:9}}},n={};function i(e){var t=n[e];if(void 0!==t)return t.exports;var o=n[e]={exports:{}};return r[e](o,o.exports,i),o.exports}i.m=r,i.d=(e,t)=>{for(var r in t)i.o(t,r)&&!i.o(e,r)&&Object.defineProperty(e,r,{enumerable:!0,get:t[r]})},i.f={},i.e=e=>Promise.all(Object.keys(i.f).reduce(((t,r)=>(i.f[r](e,t),t)),[])),i.u=e=>(({78:"page_action-aggregate",147:"metrics-aggregate",242:"session-manager",317:"jserrors-aggregate",348:"page_view_timing-aggregate",412:"lazy-feature-loader",439:"async-api",538:"recorder",590:"session_replay-aggregate",675:"compressor",733:"session_trace-aggregate",786:"page_view_event-aggregate",873:"spa-aggregate",898:"ajax-aggregate"}[e]||e)+"."+{78:"ac76d497",147:"3dc53903",148:"1a20d5fe",242:"2a64278a",317:"49e41428",348:"bd6de33a",412:"2f55ce66",439:"30bd804e",538:"1b18459f",590:"cf0efb30",675:"ae9f91a8",733:"83105561",786:"06482edd",860:"03a8b7a5",873:"e6b09d52",898:"998ef92b"}[e]+"-1.236.0.min.js"),i.o=(e,t)=>Object.prototype.hasOwnProperty.call(e,t),e={},t="NRBA:",i.l=(r,n,o,a)=>{if(e[r])e[r].push(n);else{var s,c;if(void 0!==o)for(var u=document.getElementsByTagName("script"),d=0;d {s.onerror=s.onload=null,clearTimeout(h);var i=e[r];if(delete e[r],s.parentNode&&s.parentNode.removeChild(s),i&&i.forEach((e=>e(n))),t)return t(n)},h=setTimeout(l.bind(null,void 0,{type:"timeout",target:s}),12e4);s.onerror=l.bind(null,s.onerror),s.onload=l.bind(null,s.onload),c&&document.head.appendChild(s)}},i.r=e=>{"undefined"!=typeof Symbol&&Symbol.toStringTag&&Object.defineProperty(e,Symbol.toStringTag,{value:"Module"}),Object.defineProperty(e,"__esModule",{value:!0})},i.j=364,i.p="https://js-agent.newrelic.com/",(()=>{var e={364:0,953:0};i.f.j=(t,r)=>{var n=i.o(e,t)?e[t]:void 0;if(0!==n)if(n)r.push(n[2]);else{var o=new Promise(((r,i)=>n=e[t]=[r,i]));r.push(n[2]=o);var a=i.p+i.u(t),s=new Error;i.l(a,(r=>{if(i.o(e,t)&&(0!==(n=e[t])&&(e[t]=void 0),n)){var o=r&&("load"===r.type?"missing":r.type),a=r&&r.target&&r.target.src;s.message="Loading chunk "+t+" failed.\n("+o+": "+a+")",s.name="ChunkLoadError",s.type=o,s.request=a,n[1](s)}}),"chunk-"+t,t)}};var t=(t,r)=>{var n,o,[a,s,c]=r,u=0;if(a.some((t=>0!==e[t]))){for(n in s)i.o(s,n)&&(i.m[n]=s[n]);if(c)c(i)}for(t&&t(r);u {i.r(o);var e=i(3325),t=i(5763);const r=Object.values(e.D);function n(e){const n={};return r.forEach((r=>{n[r]=function(e,r){return!1!==(0,t.Mt)(r,"".concat(e,".enabled"))}(r,e)})),n}var a=i(9144);var s=i(5546),c=i(385),u=i(8e3),d=i(5938),f=i(3960),l=i(50);class h extends d.W{constructor(e,t,r){let n=!(arguments.length>3&&void 0!==arguments[3])||arguments[3];super(e,t,r),this.auto=n,this.abortHandler,this.featAggregate,this.onAggregateImported,n&&(0,u.R)(e,r)}importAggregator(){let e=arguments.length>0&&void 0!==arguments[0]?arguments[0]:{};if(this.featAggregate||!this.auto)return;const r=c.il&&!0===(0,t.Mt)(this.agentIdentifier,"privacy.cookies_enabled");let n;this.onAggregateImported=new Promise((e=>{n=e}));const o=async()=>{let t;try{if(r){const{setupAgentSession:e}=await Promise.all([i.e(860),i.e(242)]).then(i.bind(i,3228));t=e(this.agentIdentifier)}}catch(e){(0,l.Z)("A problem occurred when starting up session manager. This page will not start or extend any session.",e)}try{if(!this.shouldImportAgg(this.featureName,t))return void(0,u.L)(this.agentIdentifier,this.featureName);const{lazyFeatureLoader:r}=await i.e(412).then(i.bind(i,8582)),{Aggregate:o}=await r(this.featureName,"aggregate");this.featAggregate=new o(this.agentIdentifier,this.aggregator,e),n(!0)}catch(e){(0,l.Z)("Downloading and initializing ".concat(this.featureName," failed..."),e),this.abortHandler?.(),n(!1)}};c.il?(0,f.b)((()=>o()),!0):o()}shouldImportAgg(r,n){return r!==e.D.sessionReplay||!1!==(0,t.Mt)(this.agentIdentifier,"session_trace.enabled")&&(!!n?.isNew||!!n?.state.sessionReplay)}}var g=i(7633),p=i(7894);class m extends h{static featureName=g.t9;constructor(r,n){let i=!(arguments.length>2&&void 0!==arguments[2])||arguments[2];if(super(r,n,g.t9,i),("undefined"==typeof PerformanceNavigationTiming||c.Tt)&&"undefined"!=typeof PerformanceTiming){const n=(0,t.OP)(r);n[g.Dz]=Math.max(Date.now()-n.offset,0),(0,f.K)((()=>n[g.qw]=Math.max((0,p.z)()-n[g.Dz],0))),(0,f.b)((()=>{const t=(0,p.z)();n[g.OJ]=Math.max(t-n[g.Dz],0),(0,s.p)("timing",["load",t],void 0,e.D.pageViewTiming,this.ee)}))}this.importAggregator()}}var v=i(1117),b=i(1284);class y extends v.w{constructor(e){super(e),this.aggregatedData={}}store(e,t,r,n,i){var o=this.getBucket(e,t,r,i);return o.metrics=function(e,t){t||(t={count:0});return t.count+=1,(0,b.D)(e,(function(e,r){t[e]=w(r,t[e])})),t}(n,o.metrics),o}merge(e,t,r,n,i){var o=this.getBucket(e,t,n,i);if(o.metrics){var a=o.metrics;a.count+=r.count,(0,b.D)(r,(function(e,t){if("count"!==e){var n=a[e],i=r[e];i&&!i.c?a[e]=w(i.t,n):a[e]=function(e,t){if(!t)return e;t.c||(t=x(t.t));return t.min=Math.min(e.min,t.min),t.max=Math.max(e.max,t.max),t.t+=e.t,t.sos+=e.sos,t.c+=e.c,t}(i,a[e])}}))}else o.metrics=r}storeMetric(e,t,r,n){var i=this.getBucket(e,t,r);return i.stats=w(n,i.stats),i}getBucket(e,t,r,n){this.aggregatedData[e]||(this.aggregatedData[e]={});var i=this.aggregatedData[e][t];return i||(i=this.aggregatedData[e][t]={params:r||{}},n&&(i.custom=n)),i}get(e,t){return t?this.aggregatedData[e]&&this.aggregatedData[e][t]:this.aggregatedData[e]}take(e){for(var t={},r="",n=!1,i=0;i t.max&&(t.max=e),e 2&&void 0!==arguments[2])||arguments[2];super(e,r,j.t,n),c.il&&((0,t.OP)(e).initHidden=Boolean("hidden"===document.visibilityState),(0,N.N)((()=>(0,s.p)("docHidden",[(0,p.z)()],void 0,j.t,this.ee)),!0),(0,O.bP)("pagehide",(()=>(0,s.p)("winPagehide",[(0,p.z)()],void 0,j.t,this.ee))),this.importAggregator())}}var P=i(3081);class C extends h{static featureName=P.t9;constructor(e,t){let r=!(arguments.length>2&&void 0!==arguments[2])||arguments[2];super(e,t,P.t9,r),this.importAggregator()}}var R,I=i(2210),k=i(1214),H=i(2177),L={};try{R=localStorage.getItem("__nr_flags").split(","),console&&"function"==typeof console.log&&(L.console=!0,-1!==R.indexOf("dev")&&(L.dev=!0),-1!==R.indexOf("nr_dev")&&(L.nrDev=!0))}catch(e){}function z(e){try{L.console&&z(e)}catch(e){}}L.nrDev&&H.ee.on("internal-error",(function(e){z(e.stack)})),L.dev&&H.ee.on("fn-err",(function(e,t,r){z(r.stack)})),L.dev&&(z("NR AGENT IN DEVELOPMENT MODE"),z("flags: "+(0,b.D)(L,(function(e,t){return e})).join(", ")));var M=i(6660);class B extends h{static featureName=M.t;constructor(r,n){let i=!(arguments.length>2&&void 0!==arguments[2])||arguments[2];super(r,n,M.t,i),this.skipNext=0;try{this.removeOnAbort=new AbortController}catch(e){}const o=this;o.ee.on("fn-start",(function(e,t,r){o.abortHandler&&(o.skipNext+=1)})),o.ee.on("fn-err",(function(t,r,n){o.abortHandler&&!n[M.A]&&((0,I.X)(n,M.A,(function(){return!0})),this.thrown=!0,(0,s.p)("err",[n,(0,p.z)()],void 0,e.D.jserrors,o.ee))})),o.ee.on("fn-end",(function(){o.abortHandler&&!this.thrown&&o.skipNext>0&&(o.skipNext-=1)})),o.ee.on("internal-error",(function(t){(0,s.p)("ierr",[t,(0,p.z)(),!0],void 0,e.D.jserrors,o.ee)})),this.origOnerror=c._A.onerror,c._A.onerror=this.onerrorHandler.bind(this),c._A.addEventListener("unhandledrejection",(t=>{const r=function(e){let t="Unhandled Promise Rejection: ";if(e instanceof Error)try{return e.message=t+e.message,e}catch(t){return e}if(void 0===e)return new Error(t);try{return new Error(t+(0,D.P)(e))}catch(e){return new Error(t)}}(t.reason);(0,s.p)("err",[r,(0,p.z)(),!1,{unhandledPromiseRejection:1}],void 0,e.D.jserrors,this.ee)}),(0,O.m$)(!1,this.removeOnAbort?.signal)),(0,k.gy)(this.ee),(0,k.BV)(this.ee),(0,k.em)(this.ee),(0,t.OP)(r).xhrWrappable&&(0,k.Kf)(this.ee),this.abortHandler=this.#e,this.importAggregator()}#e(){this.removeOnAbort?.abort(),this.abortHandler=void 0}onerrorHandler(t,r,n,i,o){"function"==typeof this.origOnerror&&this.origOnerror(...arguments);try{this.skipNext?this.skipNext-=1:(0,s.p)("err",[o||new F(t,r,n),(0,p.z)()],void 0,e.D.jserrors,this.ee)}catch(t){try{(0,s.p)("ierr",[t,(0,p.z)(),!0],void 0,e.D.jserrors,this.ee)}catch(e){}}return!1}}function F(e,t,r){this.message=e||"Uncaught error with no additional information",this.sourceURL=t,this.line=r}let U=1;const q="nr@id";function G(e){const t=typeof e;return!e||"object"!==t&&"function"!==t?-1:e===c._A?0:(0,I.X)(e,q,(function(){return U++}))}function V(e){if("string"==typeof e&&e.length)return e.length;if("object"==typeof e){if("undefined"!=typeof ArrayBuffer&&e instanceof ArrayBuffer&&e.byteLength)return e.byteLength;if("undefined"!=typeof Blob&&e instanceof Blob&&e.size)return e.size;if(!("undefined"!=typeof FormData&&e instanceof FormData))try{return(0,D.P)(e).length}catch(e){return}}}var X=i(7243);class W{constructor(e){this.agentIdentifier=e,this.generateTracePayload=this.generateTracePayload.bind(this),this.shouldGenerateTrace=this.shouldGenerateTrace.bind(this)}generateTracePayload(e){if(!this.shouldGenerateTrace(e))return null;var r=(0,t.DL)(this.agentIdentifier);if(!r)return null;var n=(r.accountID||"").toString()||null,i=(r.agentID||"").toString()||null,o=(r.trustKey||"").toString()||null;if(!n||!i)return null;var a=(0,_.M)(),s=(0,_.Ht)(),c=Date.now(),u={spanId:a,traceId:s,timestamp:c};return(e.sameOrigin||this.isAllowedOrigin(e)&&this.useTraceContextHeadersForCors())&&(u.traceContextParentHeader=this.generateTraceContextParentHeader(a,s),u.traceContextStateHeader=this.generateTraceContextStateHeader(a,c,n,i,o)),(e.sameOrigin&&!this.excludeNewrelicHeader()||!e.sameOrigin&&this.isAllowedOrigin(e)&&this.useNewrelicHeaderForCors())&&(u.newrelicHeader=this.generateTraceHeader(a,s,c,n,i,o)),u}generateTraceContextParentHeader(e,t){return"00-"+t+"-"+e+"-01"}generateTraceContextStateHeader(e,t,r,n,i){return i+"@nr=0-1-"+r+"-"+n+"-"+e+"----"+t}generateTraceHeader(e,t,r,n,i,o){if(!("function"==typeof c._A?.btoa))return null;var a={v:[0,1],d:{ty:"Browser",ac:n,ap:i,id:e,tr:t,ti:r}};return o&&n!==o&&(a.d.tk=o),btoa((0,D.P)(a))}shouldGenerateTrace(e){return this.isDtEnabled()&&this.isAllowedOrigin(e)}isAllowedOrigin(e){var r=!1,n={};if((0,t.Mt)(this.agentIdentifier,"distributed_tracing")&&(n=(0,t.P_)(this.agentIdentifier).distributed_tracing),e.sameOrigin)r=!0;else if(n.allowed_origins instanceof Array)for(var i=0;i 2&&void 0!==arguments[2])||arguments[2];super(r,n,Z.t,i),(0,t.OP)(r).xhrWrappable&&(this.dt=new W(r),this.handler=(e,t,r,n)=>(0,s.p)(e,t,r,n,this.ee),(0,k.u5)(this.ee),(0,k.Kf)(this.ee),function(r,n,i,o){function a(e){var t=this;t.totalCbs=0,t.called=0,t.cbTime=0,t.end=E,t.ended=!1,t.xhrGuids={},t.lastSize=null,t.loadCaptureCalled=!1,t.params=this.params||{},t.metrics=this.metrics||{},e.addEventListener("load",(function(r){_(t,e)}),(0,O.m$)(!1)),c.IF||e.addEventListener("progress",(function(e){t.lastSize=e.loaded}),(0,O.m$)(!1))}function s(e){this.params={method:e[0]},T(this,e[1]),this.metrics={}}function u(e,n){var i=(0,t.DL)(r);i.xpid&&this.sameOrigin&&n.setRequestHeader("X-NewRelic-ID",i.xpid);var a=o.generateTracePayload(this.parsedOrigin);if(a){var s=!1;a.newrelicHeader&&(n.setRequestHeader("newrelic",a.newrelicHeader),s=!0),a.traceContextParentHeader&&(n.setRequestHeader("traceparent",a.traceContextParentHeader),a.traceContextStateHeader&&n.setRequestHeader("tracestate",a.traceContextStateHeader),s=!0),s&&(this.dt=a)}}function d(e,t){var r=this.metrics,i=e[0],o=this;if(r&&i){var a=V(i);a&&(r.txSize=a)}this.startTime=(0,p.z)(),this.listener=function(e){try{"abort"!==e.type||o.loadCaptureCalled||(o.params.aborted=!0),("load"!==e.type||o.called===o.totalCbs&&(o.onloadCalled||"function"!=typeof t.onload)&&"function"==typeof o.end)&&o.end(t)}catch(e){try{n.emit("internal-error",[e])}catch(e){}}};for(var s=0;s 1?e[1]=i:e.push(i)}else e[0]&&e[0].headers&&s(e[0].headers,n)&&(this.dt=n);function s(e,t){var r=!1;return t.newrelicHeader&&(e.set("newrelic",t.newrelicHeader),r=!0),t.traceContextParentHeader&&(e.set("traceparent",t.traceContextParentHeader),t.traceContextStateHeader&&e.set("tracestate",t.traceContextStateHeader),r=!0),r}}function x(e,t){this.params={},this.metrics={},this.startTime=(0,p.z)(),this.dt=t,e.length>=1&&(this.target=e[0]),e.length>=2&&(this.opts=e[1]);var r,n=this.opts||{},i=this.target;"string"==typeof i?r=i:"object"==typeof i&&i instanceof Y?r=i.url:c._A?.URL&&"object"==typeof i&&i instanceof URL&&(r=i.href),T(this,r);var o=(""+(i&&i instanceof Y&&i.method||n.method||"GET")).toUpperCase();this.params.method=o,this.txSize=V(n.body)||0}function A(t,r){var n;this.endTime=(0,p.z)(),this.params||(this.params={}),this.params.status=r?r.status:0,"string"==typeof this.rxSize&&this.rxSize.length>0&&(n=+this.rxSize);var o={txSize:this.txSize,rxSize:n,duration:(0,p.z)()-this.startTime};i("xhr",[this.params,o,this.startTime,this.endTime,"fetch"],this,e.D.ajax)}function E(t){var r=this.params,n=this.metrics;if(!this.ended){this.ended=!0;for(var o=0;o 2&&void 0!==arguments[2])||arguments[2];super(e,t,we.t,r),this.importAggregator()}}new class{constructor(e){let t=arguments.length>1&&void 0!==arguments[1]?arguments[1]:(0,_.ky)(16);c._A?(this.agentIdentifier=t,this.sharedAggregator=new y({agentIdentifier:this.agentIdentifier}),this.features={},this.desiredFeatures=new Set(e.features||[]),this.desiredFeatures.add(m),Object.assign(this,(0,a.j)(this.agentIdentifier,e,e.loaderType||"agent")),this.start()):(0,l.Z)("Failed to initial the agent. Could not determine the runtime environment.")}get config(){return{info:(0,t.C5)(this.agentIdentifier),init:(0,t.P_)(this.agentIdentifier),loader_config:(0,t.DL)(this.agentIdentifier),runtime:(0,t.OP)(this.agentIdentifier)}}start(){const t="features";try{const r=n(this.agentIdentifier),i=[...this.desiredFeatures];i.sort(((t,r)=>e.p[t.featureName]-e.p[r.featureName])),i.forEach((t=>{if(r[t.featureName]||t.featureName===e.D.pageViewEvent){const n=function(t){switch(t){case e.D.ajax:return[e.D.jserrors];case e.D.sessionTrace:return[e.D.ajax,e.D.pageViewEvent];case e.D.sessionReplay:return[e.D.sessionTrace];case e.D.pageViewTiming:return[e.D.pageViewEvent];default:return[]}}(t.featureName);n.every((e=>r[e]))||(0,l.Z)("".concat(t.featureName," is enabled but one or more dependent features has been disabled (").concat((0,D.P)(n),"). This may cause unintended consequences or missing data...")),this.features[t.featureName]=new t(this.agentIdentifier,this.sharedAggregator)}})),(0,T.Qy)(this.agentIdentifier,this.features,t)}catch(e){(0,l.Z)("Failed to initialize all enabled instrument classes (agent aborted) -",e);for(const e in this.features)this.features[e].abortHandler?.();const r=(0,T.fP)();return delete r.initializedAgents[this.agentIdentifier]?.api,delete r.initializedAgents[this.agentIdentifier]?.[t],delete this.sharedAggregator,r.ee?.abort(),delete r.ee?.get(this.agentIdentifier),!1}}}({features:[J,m,S,class extends h{static featureName=oe;constructor(t,r){if(super(t,r,oe,!(arguments.length>2&&void 0!==arguments[2])||arguments[2]),!c.il)return;const n=this.ee;let i;(0,k.QU)(n),this.eventsEE=(0,k.em)(n),this.eventsEE.on(se,(function(e,t){this.bstStart=(0,p.z)()})),this.eventsEE.on(ae,(function(t,r){(0,s.p)("bst",[t[0],r,this.bstStart,(0,p.z)()],void 0,e.D.sessionTrace,n)})),n.on(ce+ne,(function(e){this.time=(0,p.z)(),this.startPath=location.pathname+location.hash})),n.on(ce+ie,(function(t){(0,s.p)("bstHist",[location.pathname+location.hash,this.startPath,this.time],void 0,e.D.sessionTrace,n)}));try{i=new PerformanceObserver((t=>{const r=t.getEntries();(0,s.p)(te,[r],void 0,e.D.sessionTrace,n)})),i.observe({type:re,buffered:!0})}catch(e){}this.importAggregator({resourceObserver:i})}},C,xe,B,class extends h{static featureName=de;constructor(e,r){if(super(e,r,de,!(arguments.length>2&&void 0!==arguments[2])||arguments[2]),!c.il)return;if(!(0,t.OP)(e).xhrWrappable)return;try{this.removeOnAbort=new AbortController}catch(e){}let n,i=0;const o=this.ee.get("tracer"),a=(0,k._L)(this.ee),s=(0,k.Lg)(this.ee),u=(0,k.BV)(this.ee),d=(0,k.Kf)(this.ee),f=this.ee.get("events"),l=(0,k.u5)(this.ee),h=(0,k.QU)(this.ee),g=(0,k.Gm)(this.ee);function m(e,t){h.emit("newURL",[""+window.location,t])}function v(){i++,n=window.location.hash,this[ve]=(0,p.z)()}function b(){i--,window.location.hash!==n&&m(0,!0);var e=(0,p.z)();this[pe]=~~this[pe]+e-this[ve],this[ye]=e}function y(e,t){e.on(t,(function(){this[t]=(0,p.z)()}))}this.ee.on(ve,v),s.on(be,v),a.on(be,v),this.ee.on(ye,b),s.on(ge,b),a.on(ge,b),this.ee.buffer([ve,ye,"xhr-resolved"],this.featureName),f.buffer([ve],this.featureName),u.buffer(["setTimeout"+le,"clearTimeout"+fe,ve],this.featureName),d.buffer([ve,"new-xhr","send-xhr"+fe],this.featureName),l.buffer([me+fe,me+"-done",me+he+fe,me+he+le],this.featureName),h.buffer(["newURL"],this.featureName),g.buffer([ve],this.featureName),s.buffer(["propagate",be,ge,"executor-err","resolve"+fe],this.featureName),o.buffer([ve,"no-"+ve],this.featureName),a.buffer(["new-jsonp","cb-start","jsonp-error","jsonp-end"],this.featureName),y(l,me+fe),y(l,me+"-done"),y(a,"new-jsonp"),y(a,"jsonp-end"),y(a,"cb-start"),h.on("pushState-end",m),h.on("replaceState-end",m),window.addEventListener("hashchange",m,(0,O.m$)(!0,this.removeOnAbort?.signal)),window.addEventListener("load",m,(0,O.m$)(!0,this.removeOnAbort?.signal)),window.addEventListener("popstate",(function(){m(0,i>1)}),(0,O.m$)(!0,this.removeOnAbort?.signal)),this.abortHandler=this.#e,this.importAggregator()}#e(){this.removeOnAbort?.abort(),this.abortHandler=void 0}}],loaderType:"spa"})})(),window.NRBA=o})(); window.jQuery || document.write(' ') CKEDITOR_BASEPATH='https://f1000research.com/js/vendor/ckeditor/' window.reactTheme = 'research'; window.MathJax = { CommonHTML: { linebreaks: { automatic: true } }, 'HTML-CSS': { linebreaks: { automatic: true } }, SVG: { linebreaks: { automatic: true } }, AuthorInit: function() { MathJax.Hub.Register.MessageHook('End Process', function () { let timeout = false; // holder for timeout id const delay = 250; // delay after event is "complete" to run callback const reflowMath = function() { const dispFormulas = document.querySelectorAll('.disp-formula.panel'); if (!dispFormulas) { return; } for (const dispFormula of dispFormulas) { const child = dispFormula.querySelector('.MathJax_Preview').nextSibling.firstChild; const isMultiline = MathJax.Hub.getAllJax(dispFormula)[0].root.isMultiline; if (dispFormula.offsetWidth < child.offsetWidth || isMultiline) { MathJax.Hub.Queue(['Rerender', MathJax.Hub, dispFormula]); } } }; window.addEventListener('resize', function() { clearTimeout(timeout); // clear the timeout timeout = setTimeout(reflowMath, delay); // start timing for event "completion" }); }); }, }; if (window.location.hash == '#_=_'){ window.location = window.location.href.split('#')[0] } !function(f,b,e,v,n,t,s){if(f.fbq)return;n=f.fbq=function() {n.callMethod? n.callMethod.apply(n,arguments):n.queue.push(arguments)} ;if(!f._fbq)f._fbq=n; n.push=n;n.loaded=!0;n.version='2.0';n.queue=[];t=b.createElement(e);t.async=!0; t.src=v;s=b.getElementsByTagName(e)[0];s.parentNode.insertBefore(t,s)}(window, document,'script','https://connect.facebook.net/en_US/fbevents.js'); fbq('init', '1641728616063202'); fbq('track', "PixelInitialized", {}); (function(h,o,t,j,a,r){ h.hj=h.hj||function(){(h.hj.q=h.hj.q||[]).push(arguments)}; h._hjSettings={hjid:2318163,hjsv:6}; a=o.getElementsByTagName('head')[0]; r=o.createElement('script');r.async=1; r.src=t+h._hjSettings.hjid+j+h._hjSettings.hjsv; a.appendChild(r); })(window,document,'https://static.hotjar.com/c/hotjar-','.js?sv='); search file_upload Submit your research search menu close search Browse Gateways & Collections How to Publish Submit your Research My Submissions Article Guidelines Article Guidelines (New Versions) Open Data, Software and Code Guidelines Open Data and Accessible Source Materials Guidelines (HSS) Open Data, Software and Code Guidelines (PSE) Prepublication Checks Production Process Posters and Slides Guidelines Document Guidelines Article Processing Charges Peer Review Finding Article Reviewers About How it Works For Reviewers Our Advisors Policies Glossary FAQs For Developers Newsroom Contact My Research Submissions Content and Tracking Alerts My Details Sign In file_upload Submit your research { "@context": "https://schema.org", "@type": "ScholarlyArticle", "mainEntityOfPage": { "@type": "WebPage", "@id": "https://f1000research.com/articles/12-73" }, "headline": "Factors associated with the use of rehabilitation services among people with disabilities in Chile: A...", "datePublished": "2023-01-18T16:35:19", "dateModified": "2025-01-17T17:03:24", "author": [ { "@type": "Person", "name": "Dania Silvia Paredes-Laguna" }, { "@type": "Person", "name": "William Romeo Calderón-Curiñaupa" }, { "@type": "Person", "name": "Sandra Liz Soto-Nuñez" }, { "@type": "Person", "name": "Adriana Berenice Espinoza-Hoempler" }, { "@type": "Person", "name": "J. Jhonnel Alarco" } ], "publisher": { "@type": "Organization", "name": "F1000Research", "logo": { "@type": "ImageObject", "url": "https://f1000research.com/img/AMP/F1000Research_image.png", "height": 480, "width": 60 } }, "image": { "@type": "ImageObject", "url": "https://f1000research.com/img/AMP/F1000Research_image.png", "height": 1200, "width": 150 }, "description": " Background Rehabilitation services are necessary for many people with disabilities to improve their functioning and be included in society. This study aimed to determine the factors associated with the use of rehabilitation services among people with disabilities in Chile in 2015. Methods This cross-sectional analysis of secondary data from Chile’s 2015 Second National Disability Study (ENDISC II) included people with disabilities aged ≥18 years. The dependent variable was the use of rehabilitation services in the previous year, and the exposure variables were sociodemographic and confounders. Poisson regression was used to determine associated factors, and prevalence ratios (PR) with their 95% confidence intervals (95% CI) were estimated. All results were weighted according to the ENDISC II complex sampling. Results A total of 2610 people with disabilities were included, and 19.1% used some rehabilitation services in the previous year. Educational level (PR 0.43; 95% CI 0.25–0.75), having a mental illness (PR 1.77; 95% CI 1.44–2.18), and caregiver assistance (PR 1.57; 95% CI 1.25–1.97) were factors associated with the use of rehabilitation services. Conclusions In 2015, one-fifth of people with disabilities in Chile used some rehabilitation services in the previous year. People with disabilities with lower educational levels were less likely to access these services. By contrast, people with mental illness and caregiver assistance were more likely to use rehabilitation services. " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/12-73", "name": "Factors associated with the use of rehabilitation services among people..." } } ] } Home Browse Factors associated with the use of rehabilitation services among people... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Paredes-Laguna DS, Calderón-Curiñaupa WR, Soto-Nuñez SL et al. Factors associated with the use of rehabilitation services among people with disabilities in Chile: A population-based study [version 2; peer review: 4 approved with reservations] . F1000Research 2025, 12 :73 ( https://doi.org/10.12688/f1000research.128242.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Revised Factors associated with the use of rehabilitation services among people with disabilities in Chile: A population-based study [version 2; peer review: 4 approved with reservations] Dania Silvia Paredes-Laguna 1 , William Romeo Calderón-Curiñaupa 1 , Sandra Liz Soto-Nuñez 1 , Adriana Berenice Espinoza-Hoempler 1 , J. Jhonnel Alarco https://orcid.org/0000-0002-0481-7072 1 Dania Silvia Paredes-Laguna 1 , William Romeo Calderón-Curiñaupa 1 , [...] Sandra Liz Soto-Nuñez 1 , Adriana Berenice Espinoza-Hoempler 1 , J. Jhonnel Alarco https://orcid.org/0000-0002-0481-7072 1 PUBLISHED 17 Jan 2025 Author details Author details 1 School of Medicine, Faculty of Health Sciences, Universidad Científica del Sur, Lima, Peru Dania Silvia Paredes-Laguna Roles: Data Curation, Investigation, Project Administration, Resources, Writing – Original Draft Preparation William Romeo Calderón-Curiñaupa Roles: Data Curation, Investigation, Project Administration, Resources, Writing – Original Draft Preparation Sandra Liz Soto-Nuñez Roles: Investigation, Resources, Writing – Original Draft Preparation Adriana Berenice Espinoza-Hoempler Roles: Investigation, Resources, Writing – Original Draft Preparation J. Jhonnel Alarco Roles: Conceptualization, Formal Analysis, Investigation, Supervision, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS This article is included in the Health Services gateway. Abstract Background Rehabilitation services are necessary for many people with disabilities to improve their functioning and be included in society. This study aimed to determine the factors associated with the use of rehabilitation services among people with disabilities in Chile in 2015. Methods This cross-sectional analysis of secondary data from Chile’s 2015 Second National Disability Study (ENDISC II) included people with disabilities aged ≥18 years. The dependent variable was the use of rehabilitation services in the previous year, and the exposure variables were sociodemographic and confounders. Poisson regression was used to determine associated factors, and prevalence ratios (PR) with their 95% confidence intervals (95% CI) were estimated. All results were weighted according to the ENDISC II complex sampling. Results A total of 2610 people with disabilities were included, and 19.1% used some rehabilitation services in the previous year. Educational level (PR 0.43; 95% CI 0.25–0.75), having a mental illness (PR 1.77; 95% CI 1.44–2.18), and caregiver assistance (PR 1.57; 95% CI 1.25–1.97) were factors associated with the use of rehabilitation services. Conclusions In 2015, one-fifth of people with disabilities in Chile used some rehabilitation services in the previous year. People with disabilities with lower educational levels were less likely to access these services. By contrast, people with mental illness and caregiver assistance were more likely to use rehabilitation services. READ ALL READ LESS Keywords rehabilitation research, people with disabilities, demographics, caregivers, Chile Corresponding Author(s) J. Jhonnel Alarco ( [email protected] ) Close Corresponding author: J. Jhonnel Alarco Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2025 Paredes-Laguna DS et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Paredes-Laguna DS, Calderón-Curiñaupa WR, Soto-Nuñez SL et al. Factors associated with the use of rehabilitation services among people with disabilities in Chile: A population-based study [version 2; peer review: 4 approved with reservations] . F1000Research 2025, 12 :73 ( https://doi.org/10.12688/f1000research.128242.2 ) First published: 18 Jan 2023, 12 :73 ( https://doi.org/10.12688/f1000research.128242.1 ) Latest published: 17 Jan 2025, 12 :73 ( https://doi.org/10.12688/f1000research.128242.2 ) Revised Amendments from Version 1 The reviewers' comments have been addressed in this revised version. Specifically, the global prevalence of disability has been updated, and the current WHO definition of rehabilitation has been incorporated. A brief explanation has been included to clarify that not all individuals with disabilities require rehabilitation. Additional information has been provided on community-based rehabilitation (CBR), with a focus on the “Rehabilitation 2030” initiative. Furthermore, a paragraph discussing the implications of the findings for public health in Chile has been added, and the bibliographic references have been updated. The reviewers' comments have been addressed in this revised version. Specifically, the global prevalence of disability has been updated, and the current WHO definition of rehabilitation has been incorporated. A brief explanation has been included to clarify that not all individuals with disabilities require rehabilitation. Additional information has been provided on community-based rehabilitation (CBR), with a focus on the “Rehabilitation 2030” initiative. Furthermore, a paragraph discussing the implications of the findings for public health in Chile has been added, and the bibliographic references have been updated. See the authors' detailed response to the review by Dorcas Gandhi See the authors' detailed response to the review by Kaloyan Kamenov READ REVIEWER RESPONSES Introduction Approximately 2.41 billion people worldwide could benefit from rehabilitation services, which mean that one in three people will need this service at some point in their lives because of an illness or injury. 1 , 2 The number of individuals experiencing reduced functionality has risen due to the aging population and the growing prevalence of chronic diseases. 3 A marked increase in the demand for physical rehabilitation services has been observed globally, with the greatest impact in resource-limited regions. 4 Rehabilitation services were estimated to become more necessary as the population ages because of the increase in people with chronic diseases 2 and the emergence of increasingly efficient medical treatments. 5 The World Health Organization (WHO) defines rehabilitation as “a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions in interaction with their environment”. 6 Recent definitions broaden its application beyond the clinical field, relating it to social, occupational, and educational interventions, independent of its location, i.e., it can be applied in hospitalized or ambulatory patients. 7 Furthermore, rehabilitation aims to achieve independence, minimize pain and distress, and improve the ability to adapt and respond to circumstantial changes. 8 Rehabilitation services are available to individuals at any stage of life and are vital for achieving universal health coverage. 2 People with disabilities require comprehensive healthcare that encompasses prevention and health promotion and may also need rehabilitation services to optimize functionality and mitigate disability. 9 The Global Report on Health Equity for Persons with Disabilities estimates that 1.3 billion people, or 16% of the global population, experience a significant disability. 10 An analysis of eight population censuses conducted in Latin America and the Caribbean between 2010 and 2012, which employed the Washington Group questions to assess disability, reported the highest prevalence in Brazil at 24.9%, followed by Uruguay at 17.0%. 11 Access to rehabilitation services for people with disabilities depends on various factors, such as personal and environmental factors. 9 Likewise, disability is associated with several inequity factors that push the person to a situation of social, individual, and family exclusion. To reduce these inequities, the WHO created a strategy called “ community-based rehabilitation ” (CBR), which provides rehabilitation services in the community with equal opportunities and social inclusion and training to people with disabilities, their families, and community members. 12 Similarly, in 2017, the Rehabilitation 2030 initiative was launched to ensure that rehabilitation is recognized as an essential service for achieving universal health coverage and is accessible to the entire population at all stages of life. 2 During its third meeting in May 2023, rehabilitation was officially acknowledged as a global public health priority, and priority actions for implementation by member countries were defined. 13 In Chile, it was implemented between 2004 and 2015, with the objective that 10% of the people served in community rehabilitation centers achieve social inclusion. However, a study using data from all community rehabilitation centers up to December 2016 indicated that the strategy had not been appropriately adopted. This study found that although all centers had physical and occupational therapists, less than half had professionals from other rehabilitation areas such as speech therapists, nurses, psychologists, or nursing technicians, which impedes the correct implementation of CBR due to a lack of trained human resources. 14 In 2021, the Chilean Ministry of Health developed and implemented the first National Rehabilitation Plan for 2021–2030. This plan aligns with international recommendations while addressing Chile's specific context to ensure timely and continuous access to high-quality rehabilitation services. The plan is informed by epidemiological data and incorporates ongoing assessments of rehabilitation needs. 15 , 16 Therefore, it is essential to understand the situation in Chile, a country with the highest prevalence of people with disabilities in Latin America. 17 Few studies in this region have examined the determinants influencing access to rehabilitation services. The findings from this analysis will help address disparities in individuals with disabilities' access to rehabilitation. Accordingly, this study aimed to determine the factors associated with using rehabilitation services among people with disabilities in Chile in 2015. Methods Study design This analytical cross-sectional study analyzed secondary data from Chile’s 2015 Second National Disability Study (ENDISC II). 18 The study population consisted of residents of urban and rural areas of the 135 communes of the 15 regions of Chile. ENDISC II was conducted between June 30 and September 5, 2015. 19 Setting ENDISC II is a population-based survey that aims to “determine the prevalence and characterize disability at the national level, identifying the main gaps in access to persons with disabilities”. 18 It was conducted jointly by the Ministry of Social Development (MDS) and the National Statistics Institute (INE) and supervised by the National Disability Service (SENADIS) of Chile. 19 ENDISC II used a probabilistic sampling in two phases. The first phase used a list of households from a previous survey (Case 2013), and the second phase systematically selected households within the strata (communes and rural–urban areas). The final selection unit was the dwelling. ENDISC II’s design allows its results to be nationally and regionally representative because it covers 80% of the total number of households in Chile. Data collection was conducted through personal interviews with paper questionnaires. The surveys were applied to 12,015 dwellings, which included 12,265 people aged ≥18 years. Details of the sample design can be reviewed in their methodology book. 18 Participants For this study, we included persons with disabilities aged >18 years of both sexes and excluded records with missing or inconsistent data on the variables of interest. Measurement of disability To measure the prevalence of disability, ENDISC II applied a methodology based on the Model Disability Survey (MDS) used by the WHO in the II World Report on Disability, which measures three aspects, namely, functioning, capacity and environmental factors. 18 The MDS was developed after the review of 179 health and disability surveys from around the world, following the implementation of the ICF in 2001. 20 The application of this methodology in the Americas is novel because it is different from surveys that use few questions to identify persons with disabilities, such as those of the Washington group. 21 This methodology is based on the item response theory and uses a metric scale that places different questions associated with greater or lesser disability. Thus, it is possible to identify the degrees of difficulty and adequately estimate the total prevalence of disability. 18 Variables The outcome variable was rehabilitation services in the previous year for persons with disabilities. This variable is of a nominal qualitative type and was measured with the question, “In the last 12 months, did you receive any rehabilitation services?” The response categories were yes and no. The exposure variables were sex (male and female), age group (18–29, 30–44, 55–59, and 60+), educational level (no education, elementary, middle, and high school), marital status (married/cohabiting, widowed/separated/divorced, and single), origin (urban and rural), indigenous identification (no and yes), current job (no and yes), health insurance system (FONASA, FFAA, and Order, ISAPRE, none or private, and other/does not know), chronic diseases (which included diabetes, hypertension, arthritis/arthrosis, heart diseases, respiratory diseases, migraine, and AIDS/HIV diagnosed by a doctor; “Has a doctor ever told you that you have [name of disease/health condition]?” no and yes; mental illness (which included persons with physician-diagnosed anxiety and depression; “Have you ever been told by a doctor that you have [name of disease/health condition]?” no and yes), recreational activities (“During the past 6 months, did you engage in or attend the following activities or places?” no and yes), physical activity (“In the past month, did you play sports or engage in physical activity outside of your work schedule, for 30 min or more?” no and yes), caregiver assistance (“Because of your health, do you have someone to help you at home or outside your home, including family and friends, to perform the following activities?” no and yes), and perceived discrimination “In the past 12 months, have you felt discriminated against (i.e., been prevented from doing something, bothered, or made to feel inferior?” no and yes). Bias Self-reporting bias may increase the prevalence of disability. 22 However, surveys and population censuses have widely used self-reported questions to measure this condition. For example, the Washington Group questions measure disability quickly, effectively, and economically and have been used in more than 69 national censuses worldwide. 23 ENDISC II also uses self-report questions through an interview conducted by trained enumerators and has already been applied in 10 countries, Chile being the first in Latin America. 20 Statistical processing and analysis The data were downloaded from the SENADIS web page and analyzed with STATA version 16 (Stata Corporation, College Station, TX, USA). To select the subgroup of people with disabilities aged >18 years, the variable disc_adult was used through the sub pop command. Frequency distribution tables and weighted percentages with their 95% confidence intervals (95% CI) were prepared. In the bivariate analysis, to evaluate differences in the characteristics of people with disabilities who use or do not use rehabilitation services, the chi-square test was corrected with the F statistic for survey design. In the multivariate analysis, Poisson regression was used to estimate prevalence ratios (PR) with their 95% CI. A crude model was developed, and variables having a p-value <0.25 were included in the adjusted model. All results were weighted according to the complex sample design of the ENDISC II. A p-value of p <0.05 was assumed to be statistically significant. The possible multicollinearity among the variables of the adjusted model was also checked through the manual calculation of the variance inflation factor (VIF). 24 A VIF ≥10 was an indication of collinearity. We did not perform any stratification according to sex, as previous studies have not shown that this variable is associated with the use of rehabilitation services in people with disabilities. 25 Ethical aspects The ENDISC II database is publicly accessible and available on the SENADIS website. Data are coded and do not allow the identification of participants. The Human Medicine career approved the present secondary analysis of the Universidad Científica del Sur. It was exempted from review by the institutional ethics committee according to resolution N° 407-DACMH-DAFCS-U. CIENTIFICA-2022, issued on August 1, 2022. Results The database had information on 2,618 persons with disabilities. We excluded eight due to a lack of data on the variables of interest (2 in educational level, 2 in indigenous identification, and 4 in the health insurance system). Finally, we included 2610 persons with disabilities, of whom 64.3% were women, and 47.3% were 60 or older. A total of 39.3% had elementary education, and 54% reported being married or cohabiting. Most were from urban areas and did not identify with indigenous populations (86.5% and 92.6%, respectively). Most of the participants (66.6%) did not have a job at the time of the survey, and 84 (8%) had the National Health Fund (NASA) as their healthcare provider. Likewise, 74.2% and 68.2% reported having a chronic illness and mental illness, respectively. In addition, 75% were engaged in recreational activities, and 17% were physically active. Moreover, 41.2% had a caregiver, and 23.7% had perceived discrimination. Finally, 19.1% admitted that they had used some rehabilitation service in the last 12 months ( Table 1 ). Table 1. Characteristics of people with disabilities in Chile (n=2,610). Variables n % a 95% CI Sex Male 801 35.7 33.0–38.4 Female 1,809 64.3 61.6–67.0 Age group 18–29 173 8.3 6.8–10.1 30–44 356 12.8 11.1–14.7 55–59 758 31.6 29.2–34.2 60+ 1,323 47.3 44.5–50.1 Educational level No education 191 7.5 6.2–9.0 Elementary 1,077 39.3 36.6–42.2 Middle 986 38.2 35.7–40.7 High school 356 15.0 13.0–17.3 Marital status Married/cohabiting 1,181 54.0 51.4–56.5 Widowed/separated/divorced 841 24.8 22.6–27.2 Single 588 21.2 19.1–23.5 Origin Urban 2,176 86.5 84.2–88.6 Rural 434 13.5 11.4–15.8 Indigenous identification No 2,388 92.6 91.2–93.9 Yes 222 7.4 6.2–8.9 Current job No 1,778 66.6 63.9–69.2 Yes 832 33.4 30.7–36.1 Health insurance system FONASA 2,225 84.8 82.8–86.7 FFAA, and order 60 1.8 1.3–2.5 ISAPRE 168 8.2 6.7–10.0 None or private 95 3.0 2.3–4.0 Other/does not know 62 2.2 1.5–3.0 Chronic diseases b No 633 25.8 23.4–28.3 Yes 1,977 74.2 71.7–76.6 Mental illness c No 1,784 68.2 65.4–70.8 Yes 826 31.8 29.2–34.6 Recreational activities No 639 25.3 22.9–27.8 Yes 1,971 74.7 72.2–77.1 Physical activity No 2,165 82.9 80.8–84.9 Yes 445 17.1 15.1–19.2 Caregiver assistance No 1,560 58.8 55.9–61.6 Yes 1,050 41.2 38.4–44.0 Perceived discrimination No 1,965 76.3 74.0–78.6 Yes 645 23.7 21.3–26.2 Rehabilitation No 2,107 80.9 78.7–82.9 Yes 503 19.1 17.1–21.3 a Percentage weighted according to ENDISC II complex sampling. b Included diabetes, hypertension, arthritis/arthrosis, heart diseases, respiratory diseases, migraine, and AIDS/HIV diagnosed by a doctor. c Included anxiety and depression diagnosed by a doctor. In the bivariate analysis, a higher prevalence of the use of rehabilitation services was found in persons with disabilities who had a provisional health system, mainly in those who received care in Social Security Health Institutions (ISAPRE), with 28.9% (p < 0.028). Similarly, in persons with disabilities and mental illness, the prevalence of rehabilitation services was 27.6% compared with persons with disabilities who did not have a mental illness, with 15.1% (p < 0.001). A higher prevalence of the use of rehabilitation services was also found in persons with disabilities who had a caregiver (23.3%) compared with those without a caregiver (16.2%) (p = 0.001) ( Table 2 ). Table 2. Characteristics of people with disabilities in Chile according to use of rehabilitation services (n=2,610). Variable Use of rehabilitation services P-value a No, n (%) Yes, n (%) Sex 0,776 Male 660 (81.4) 141 (18.6) Female 1,447 (80.7) 362 (19.3) Age group 0.326 18–29 139 (80.9) 34 (19.1) 30–44 305 (85.2) 51 (14.8) 55–59 596 (78.4) 162 (21.6) 60+ 1,067 (81.4) 256 (18.6) Educational level 0.063 No education 167 (87.5) 24 (12.5) Elementary 879 (82.1) 198 (17.9) Middle 791 (80.6) 195 (19.4) High school 270 (75.3) 86 (24.7) Marital status 0.204 Married/cohabiting 969 (82.6) 212 (17.4) Widowed/separated/divorced 663 (78.5) 178 (21.5) Single 475 (79.5) 113 (20.5) Origin 0.987 Urban 1,744 (80.9) 432 (19.1) Rural 363 (80.9) 71 (19.1) Indigenous identification 0.087 No 1,920 (80.5) 468 (19.5) Yes 187 (86.2) 35 (13.8) Current job 0.732 No 1,420 (80.6) 358 (19.4) Yes 687 (81.5) 145 (18.5) Health insurance system 0.028 FONASA 1,806 (81.5) 419 (18.5) FFAA, and Order 47 (82.0) 13 (18.0) ISAPRE 118 (71.1) 50 (28.9) None or private 82 (86.6) 13 (13.4) Other/does not know 54 (87.4) 8 (12.6) Chronic diseases b 0.509 No 534 (82.2) 99 (17.8) Yes 1,573 (80.4) 404 (19.6) Mental illness c < 0.001 No 1,515 (84.9) 269 (15.1) Yes 592 (72.4) 234 (27.6) Recreational activities 0.747 No 514 (81.5) 125 (18.5) Yes 1,593 (80.7) 378 (19.3) Physical activity 0.670 No 1,746 (81.1) 419 (18.9) Yes 361 (79.9) 84 (20.1) Caregiver assistance 0.001 No 1,308 (83.8) 252 (16.2) Yes 799 (76.7) 251 (23.3) Perceived discrimination 0.102 No 1,601 (81.9) 364 (18.1) Yes 506 (77.9) 139 (22.1) a Chi-square test. b Included diabetes, hypertension, arthritis/arthrosis, heart diseases, respiratory diseases, migraine, and AIDS/HIV diagnosed by a doctor. c Included anxiety and depression diagnosed by a doctor. In the crude model, the variables that were significantly associated with the use of rehabilitation services were primary education (PR 0.72; 95% CI 0.53–0.99, p < 0.043), no education (PR 0.5; 95% CI 0.32–0.80, p < 0.004), marital status (PR 1.24; 95% CI 0.97–1.58, p = 0.078), indigenous identification (PR 0.71; 95% CI 0.47–1.08, p = 0.109), health insurance system in the ISAPRE category (PR 1.56, 95% CI 1.10–2.23, p = 0.015), mental illness (PR 1.83; 95% CI 1.48–2.25, p < 0.001), caregiver assistance (PR 1.44; 95% CI 1.16–1.79, p = 0.001), and perception of discrimination (PR 1.22; 95% CI 0.96–1.55, p = 0.104). Other variables such as sex, age groups, origin, current job, chronic disease, recreational activities, and physical activity were not significantly associated with rehabilitation services ( Table 3 ). Table 3. Factors associated with the use of rehabilitation services among people with disabilities in Chile (n=2,610). Variables Crude model P-value Adjusted model P-value PR (95% CI) PR (95% CI) Sex Male Reference Female 1.04 (0.80–1.34) 0.777 Age group 18–29 Reference 30–44 0.78 (0.44–1.39) 0.396 55–59 1.13 (0.70–1.82) 0.610 60+ 0.97 (0.61–1.57) 0.916 Educational level No education 0.50 (0.32–0.80) 0.004 0.43 (0.25–0.75) 0.003 Elementary 0.72 (0.53–0.99) 0.043 0.74 (0.52–1.06) 0.101 Middle 0.78 (0.57–1.07) 0.117 0.85 (0.62–1.18) 0.334 High school Reference Reference Marital status Married/cohabiting Reference Reference Widowed/separated/divorced 1.24 (0.98-1.57) 0.078 1.22 (0.95–1.56) 0.126 Single 1.18 (0.88-1.57) 0.270 1.18 (0.88-1.58) 0.274 Origin Urban Reference Rural 0.99 (0.76–1.31) 0.988 Indigenous identification No Reference Reference Yes 0.71 (0.47–1.08) 0.109 0.81 (0.53-1.24) 0.338 Current job No Reference Yes 0.96 (0.75–1.23) 0.733 Health insurance system FONASA Reference Reference FFAA, and Order 0.97 (0.53–1.77) 0.927 1.07 (0.59–1.94) 0.815 ISAPRE 1.56 (1.10–2.23) 0.015 1.41 (0.97–2.07) 0.074 None or private 0.72 (0.38–1.38) 0.323 0.73 (0.39–1.35) 0.311 Other/does not know 0.68 (0.29–1.57) 0.363 0.76 (0.34–1.68) 0.499 Chronic diseases a No Reference Yes 1.10 (0.83–1.47) 0.512 Mental illness b No Reference Reference Yes 1.83 (1.48–2.25) < 0.001 1.77 (1.44–2.18) <0.001 Recreational activities No Reference Yes 1.04 (0.81–1.33) 0.748 Physical activity No Reference Yes 1.06 (0.80–1.41) 0.664 Caregiver assistance No Reference Reference Yes 1.44 (1.16–1.79) 0.001 1.57 (1.25–1.97) <0.001 Perceived discrimination No Reference Reference Yes 1.22 (0.96–1.55) 0.104 1.17 (0.92–1.48) 0.208 a Included diabetes, hypertension, arthritis/arthrosis, heart diseases, respiratory diseases, migraine, and AIDS/HIV diagnosed by a doctor. b Included anxiety and depression diagnosed by a doctor. The adjusted model’s associated variables were educational level, mental illness, and caregiver assistance. Persons with disability without education were 57% less likely to use rehabilitation services (PR 0.43; 95% CI 0.25–0.75, p = 0.003) than persons with disability with higher education. Likewise, persons with disability who had a mental illness were 77% more likely to use rehabilitation services than persons with disability who did not have a mental illness (PR 1.77; 95% CI 1.44–2.18, p < 0.001). Persons with disabilities who had caregiver assistance were 57% more likely to use rehabilitation services than persons with disabilities who have no caregiver assistance (PR 1.57; 95% CI 1.25–1.97, p < 0.001), all adjusted for educational level, marital status, ethnic identification, health insurance system, mental illness, assistance of a caregiver, and perception of discrimination ( Table 3 ). In the adjusted model, no evidence of multicollinearity was found among the variables (VIF < 10). Discussion The results of this study show that in 2015, one-fifth of the people with disabilities in Chile used some rehabilitation services in the previous year. In addition, low educational level, mental illness, and caregiver assistance were significantly associated with the use of rehabilitation services. Prevalence of the use of rehabilitation services in people with disabilities Approximately 19.1% of people with disabilities in Chile used some rehabilitation services in the previous year. Similar studies have reported varying findings. For instance, a population-based analysis of 13,659 individuals with disabilities in southern Brazil found that only 9.2% of people used rehabilitation services. 26 A study in a Ugandan community of 318 randomly selected persons with physical disabilities reported a prevalence of 26.4% of rehabilitation service utilization. 25 Another study in Uganda of 284 persons with physical disabilities receiving CBR services found a prevalence of access to rehabilitation services of 41.1%, although only 6.8% had access to physical therapy. 20 This variability in the prevalence of rehabilitation services could be explained by the diversity of methodological designs, different instruments used to measure disability, or differences in access to rehabilitation services. As long as methodologies for measuring disability are not standardized, these differences will remain unexplained. Thus, caution should be exercised when comparing similar studies. Factors associated with the use of rehabilitation services People with disabilities with lower educational levels were less likely to use rehabilitation services than those with higher education levels. These results are consistent with studies conducted in Uganda, 25 Brazil, 28 – 30 Poland, 31 and Peru, 32 which indicates that low educational level decreases the use of rehabilitation services. A study in Spain also found that older adults with low educational level were more likely to have a functional disability. 33 In this regard, several population-based studies have shown that educational disparities are associated with a higher incidence of disability 34 , 35 ; this may be attributed to environmental barriers, including the lack of accessible educational materials, inadequate school infrastructure, and negative attitudes among teachers. Moreover, limited economic resources would increase these inequalities. 36 The higher prevalence of disability among individuals with lower educational levels or limited access to information about the availability of rehabilitation services may explain the greater need for such services observed in our study. People with disabilities and mental illnesses such as depression or anxiety were more likely to use rehabilitation services. Depression and disability have a reciprocal association. Several factors, such as social stereotyping, abuse, poverty, environmental barriers, or lack of access to health services, predispose people with disabilities to suffer up to depressive symptoms three times more than their non-disabled peers; moreover, depression can lead to disability. 37 This association is clearly described in several studies. 38 , 39 However, there is limited information on depression and its association with the use of rehabilitation services in people with disabilities. Some studies have shown results similar to ours. In 3,568 adults with disabilities in Korea, those who received rehabilitation services had a higher risk of depressive symptoms than those who did not (OR 1.23; 95% CI 1.01–1.50). 40 A population-based study of 195,033 Americans found a higher prevalence of depressive symptoms in adults with disabilities who used assistive technologies (30.4%) than those who did not (7.4%). 41 Another study in Germany involving 4,020 patients with cancer reported a higher prevalence of depression in those patients coming from cancer rehabilitation centers (28%) compared with inpatients (24%) or outpatients (21%), increasing this probability up to six times. 42 According to our findings and the reviewed evidence, individuals with disabilities who utilized rehabilitation services were more likely to have a physician-diagnosed anxiety or depression. These conditions may be more closely associated with the disability itself rather than the need for rehabilitation services. However, factors intrinsic to the rehabilitation process—such as pain, feelings of embarrassment, or frustration arising from prolonged rehabilitation or the permanence of the disability—could also contribute to this association. Information on this topic is limited, but some studies have described this explanation. 40 Finally, people with disabilities who have caregiver assistance were more likely to use rehabilitation services. People with disabilities may need a caregiver to perform basic activities of daily living. 43 A population-based study in Peru found that 40.5% of people with disabilities were dependent on a caregiver; this function was mainly assumed by female family members. 32 The role of the caregiver mainly falls on a family member, either the children or the partner. 44 A study in China conducted on informal caregivers of people with intellectual disabilities found that 85% of the caregivers were the parents of the patients. 45 Therefore, family members would have an essential role in the decision to access rehabilitation services, especially in those with severe limitations and almost absolute dependence on the caregiver. This explanation has been postulated by Medeiros et al . to justify the high prevalence of rehabilitation services in minors with disabilities. 26 Although individuals with disabilities are generally autonomous and capable of making their own decisions, they may, in certain cases, require a caregiver. Caregivers play a fundamental role in the success of rehabilitation by serving as a vital communication link between the physician and the patient. Additionally, healthcare professionals rely on caregivers to facilitate and extend the rehabilitation process in the home setting. 46 Implications for public health The results of this study have significant public health implications for Chile. Efforts must focus on improving equity in access to rehabilitation services, ensuring that individuals with disabilities and lower educational attainment are not excluded from these essential services. Strengthening the early detection and intervention of mental illnesses in individuals with disabilities is also crucial, given their increased need for rehabilitation. Lastly, it is imperative to integrate caregivers into rehabilitation plans, acknowledging their pivotal role in facilitating access and promoting adherence to treatment. Limitations This study has some limitations. First, social desirability bias or recall bias may have influenced survey responses, potentially leading to an overestimation or underestimation of the reported prevalence of rehabilitation service use among individuals with disabilities. Second, certain factors associated with the use of rehabilitation services, such as transportation challenges, architectural barriers, or the quality of medical care, were not captured in the ENDISC II survey. Similarly, for some variables, such as caregiver assistance, the specific type of care provided to individuals with disabilities remains unknown. Third, stratification according to age groups was not performed; in older adults, the associated factors may vary concerning other age groups. Fourth, the use of rehabilitation services only included the last 12 months. Their use before that time is unknown, especially in patients with chronic disabilities. Fifth, some categories of the exposure variables may not have an adequate sample size to show an association with the use of rehabilitation services. Sixth, causality between the main variables cannot be affirmed because of the study’s cross-sectional design. As a strength, ENDISC II is a population-based survey; thus, the results of this study would be representative of people with disabilities in Chile. Conclusions In Chile, in 2015, one-fifth of people with disabilities used some rehabilitation service in the previous year. People with lower educational levels were less likely to access this service. Having a mental illness, such as depression, and receiving caregiver assistance significantly increased the likelihood of accessing rehabilitation services. These results should guide health professionals in identifying depressive or anxious conditions that may impair compliance and correct performance of therapies. Likewise, it is necessary to encourage the caregiver to participate in the rehabilitation therapies of a person with disability. Finally, future studies should include a more significant number of possible factors that may explain the use of rehabilitation services in persons with disabilities. Data availability Underlying data ENDISC II data is available on the website of the National Disability Service (SENADIS) of Chile: https://www.senadis.gob.cl/pag/356/1625/base_de_datos . The data is available in SPSS or Stata form and a codebook is available (Spanish). Extended data figshare: [Extended data] Factors associated with the use of rehabilitation services among people with disabilities in Chile: A population-based study. https://doi.org/10.6084/m9.figshare.21749291 . 47 This project contains the following extended data: • Supplementary material (Table of operationalization of variables – this provides English translations of the relevant column labels/questions in the data file, as well as a data key) • Stata do-file (Contains the commands used for data analysis) • The ENDISC II questionnaire (Spanish) Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0). References 1. Cieza A, Causey K, Kamenov K, et al. : Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2021 Dec 19; 396 (10267): 2006–2017. PubMed Abstract | Publisher Full Text | Free Full Text 2. World Health Organization: Rehabilitation 2030.[cited 2024 Sep 10]. Reference Source 3. Sainz de Murieta E, Cisneros MT: [Rehabilitation and functional capacity in the health of the 21st century].An. Sist Sanit. Navar [Internet].2022 Dec 30; 45 (3). PubMed Abstract | Publisher Full Text | Free Full Text 4. Jesus TS, Arango-Lasprilla JC, Kumar Kamalakannan S, et al. : Growing physical rehabilitation needs in resource-poor world regions: secondary, cross-regional analysis with data from the global burden of disease 2017. Disabil. Rehabil [Internet]. 2022 Sep; 44 (19): 5429–5439. PubMed Abstract | Publisher Full Text 5. Li Z, Zhang Z, Ren Y, et al. : Aging and age-related diseases: from mechanisms to therapeutic strategies. Biogerontology. 2021 Apr; 22 (2): 165–187. PubMed Abstract | Publisher Full Text | Free Full Text 6. World Health Organization: Rehabilitation [Internet]. [cited 2024 Aug 26]. Reference Source 7. Meyer T, Kiekens C, Selb M, et al. : Toward a new definition of rehabilitation for research purposes: a comparative analysis of current definitions. Eur. J. Phys. Rehabil. Med. 2020 Oct; 56 (5): 672–681. PubMed Abstract | Publisher Full Text 8. Wade DT: What is rehabilitation? An empirical investigation leading to an evidence-based description. Clin. Rehabil. 2020 May; 34 (5): 571–583. PubMed Abstract | Publisher Full Text | Free Full Text 9. Clemente KAP, Silva SV da, Vieira GI, et al. : Barriers to the access of people with disabilities to health services: a scoping review.Rev. Saude Publica [Internet].2022 Jul; 56 : 64. PubMed Abstract | Publisher Full Text | Free Full Text 10. World Health Organization: Global report on health equity for persons with disabilities [Internet].World Health Organization; 2022 [cited 2024 Aug 27]. Reference Source 11. Berlinski S, Duryea S, Perez-Vincent SM: Prevalence and correlates of disability in Latin America and the Caribbean: Evidence from 8 national censuses.PLoS One [Internet].2021 Oct 27; 16 (10): e0258825. PubMed Abstract | Publisher Full Text | Free Full Text 12. Grills N, Varghese J: Disability and community-based rehabilitation. In: Lankester T, Grills N, editors. Setting up Community Health and Development Programmes in Low and Middle Income Settings [Internet].Oxford: Oxford University Press; 2019. pp. 404–417. Publisher Full Text Reference Source 13. World Health Organization: Strengthening rehabilitation in health systems [Internet]. WHO 2023 May. Reference Source 14. Besoain-Saldaña Á, Sanhueza JR, Hizaut MM, et al. : Community-Based Rehabilitation (CBR) in primary care centers in Chile. Rev. Saude Publica. 2020 Apr 6; 54 : 38. PubMed Abstract | Publisher Full Text | Free Full Text 15. Seijas V, Hrzic KM, Neculhueque XZ, et al. : Improving Access to and Coverage of Rehabilitation Services through the Implementation of Rehabilitation in Primary Health Care: A Case Study from Chile.Health Syst. Reform [Internet].2023 Dec 31; 9 (1). PubMed Abstract | Publisher Full Text 16. Subsecretaría de Salud Pública: Plan Nacional de Rehabilitación 2021-2030 [Internet]. Ministerio de Salud. 2021 Aug. Reference Source 17. Red Latinoamericana de Organizaciones de Personas con Discapacidad y sus Familias (RIADIS): Informe regional sobre la implementación de los objetivos de desarrollo sostenible en América Latina bajo el enfoque de la convención de los derechos de las personas con discapacidad [Internet]. RIADIS. 2019 Mar; Reference Source 18. Servicio Nacional de la Discapacidad: Libro de resultados II Estudio Nacional de la Discapacidad. SENADIS; 2015. Reference Source 19. Servicio Nacional de la Discapacidad: Metodología de diseño muestral de la encuesta del Segundo Estudio Nacional de la Discapacidad, 2015. Santiago: SENADIS; 2016. Reference Source 20. Sabariego C, Fellinghauer C, Lee L, et al. : Generating comprehensive functioning and disability data worldwide: development process, data analyses strategy and reliability of the WHO and World Bank Model Disability Survey. Arch. Public Health. 2022 Jan 4; 80 (1): 6. PubMed Abstract | Publisher Full Text | Free Full Text 21. The Washington Group on Disability Statistics: The Washington Group on Disability Statistics. [Internet]. [cited 2023 Jun 29]. Reference Source 22. Althubaiti A: Information bias in health research: definition, pitfalls, and adjustment methods. J. Multidiscip. Healthc. 2016 May 4; 9 : 211–217. PubMed Abstract | Publisher Full Text | Free Full Text 23. Groce NE, Mont D: Counting disability: emerging consensus on the Washington Group questionnaire. Lancet Glob. Health. 2017 Jul; 5 (7): e649–e650. PubMed Abstract | Publisher Full Text 24. How can I check for collinearity in survey regression? [Internet]. [cited 2023 Jul 23]. Reference Source 25. Zziwa S, Babikako H, Kwesiga D, et al. : Prevalence and factors associated with utilization of rehabilitation services among people with physical disabilities in Kampala, Uganda. A descriptive cross sectional study. BMC Public Health. 2019 Dec 27; 19 (1): 1742. PubMed Abstract | Publisher Full Text | Free Full Text 26. Medeiros A d A, Galvão MHR, Barbosa IR, et al. : Use of rehabilitation services by persons with disabilities in Brazil: A multivariate analysis from Andersen’s behavioral model. PLoS One. 2021 Apr 29; 16 (4): e0250615. PubMed Abstract | Publisher Full Text | Free Full Text 27. Hamid LN, Kobusingye O, Baine SO, et al. : Disability Characteristics of Community-Based Rehabilitation Participants in Kayunga District, Uganda. Ann. Glob. Health. 2017 May; 83 (3–4): 478–488. PubMed Abstract | Publisher Full Text | Free Full Text 28. Moretto LC, Longo GZ, Boing AF, et al. . Prevalência da utilização de serviços de fisioterapia entre a população adulta urbana de Lages, Santa Catarina. Braz. J. Phys. Ther. 2009 Apr [cited 2022 Aug 12]; 13 (2): 130–5. 10 Publisher Full Text 29. Pereira GN, Bastos GAN, Del Duca GF, et al. : Indicadores demográficos e socioeconômicos associados à incapacidade funcional em idosos. Cad Saúde Pública. 2012 Nov [cited 2022 Aug 12]; 28 (11): 2035–2042. PubMed Abstract | Publisher Full Text 30. Amaral FL, Motta MHA, da Silva LPG , et al. : Fatores associados com a dificuldade no acesso de idosos com deficiência aos serviços de saúde. Ciênc Saúde Coletiva. 2012 Nov [cited 2022 Aug 12]; 17 (11): 2991–3001. PubMed Abstract | Publisher Full Text 31. Szybalska A, Broczek K, Slusarczyk P, et al. : Utilization of medical rehabilitation services among older Poles: results of the PolSenior study. Eur. Geriatr. Med. 2018 Jun 20; 9 (5): 669–677. PubMed Abstract | Publisher Full Text | Free Full Text 32. Bernabe-Ortiz A, Diez-Canseco F, Vásquez A, et al. : Disability, caregiver’s dependency and patterns of access to rehabilitation care: results from a national representative study in Peru. Disabil. Rehabil. 2016; 38 : 582–588. PubMed Abstract | Publisher Full Text 33. Carmona-Torres JM, Rodríguez-Borrego MA, Laredo-Aguilera JA, et al. : Disability for basic and instrumental activities of daily living in older individuals PLoS One [Internet]. 2019 Jul 26; 14 (7): e0220157. PubMed Abstract | Publisher Full Text | Free Full Text 34. Townsend T, Mehta NK: Pathways to educational disparities in disability incidence: The contributions of excess body mass index, smoking, and manual labor involvement. J. Gerontol. B Psychol. Sci. Soc. Sci [Internet]. 2021 Mar 14; 76 (4): 766–777. PubMed Abstract | Publisher Full Text | Free Full Text 35. Sharma S, Hale JM, Myrskylä M, et al. : Racial, ethnic, nativity, and educational disparities in cognitive impairment and activity limitations in the United States, 1998-2016. Demography [Internet]. 2023 Oct 1; 60 (5): 1441–1468. PubMed Abstract | Publisher Full Text 36. Klijs B, Nusselder WJ, Looman CW, et al. : Educational disparities in the burden of disability: contributions of disease prevalence and disabling impact. Am. J. Public Health. 2014 Aug; 104 (8): e141–e148. PubMed Abstract | Publisher Full Text | Free Full Text 37. Behrens-Wittenberg E, Wedegaertner F: Identifying individuals at high risk for permanent disability from depression and anxiety. Front. Psychiatry [Internet]. 2020 Jul 31; 11 : 740. PubMed Abstract | Publisher Full Text | Free Full Text 38. Shen SC, Huang KH, Kung PT, et al. : Incidence, risk, and associated factors of depression in adults with physical and sensory disabilities: A nationwide population-based study. PLoS One. 2017 Mar 31; 12 (3): e0175141. Publisher Full Text 39. Karki P, Shahi PV, Sapkota KP, et al. : Depressive symptoms and associated factors among persons with physical disabilities in disability care homes of Kathmandu district, Nepal: A mixed method study.PLOS Glob. Public Health [Internet].2023 Jan 12; 3 (1): e0001461. PubMed Abstract | Publisher Full Text | Free Full Text 40. Lee Y, Hong I, Lee MJ, et al. : Identifying Risk of Depressive Symptoms in Adults With Physical Disabilities Receiving Rehabilitation Services: Propensity Score Approaches. Ann. Rehabil. Med. 2019 Jun; 43 (3): 250–261. PubMed Abstract | Publisher Full Text | Free Full Text 41. Okoro CA, Strine TW, Balluz LS, et al. : Prevalence and correlates of depressive symptoms among United States adults with disabilities using assistive technology. Prev. Med. 2010 Apr; 50 (4): 204–209. PubMed Abstract | Publisher Full Text 42. Hartung TJ, Brähler E, Faller H, et al. : The risk of being depressed is significantly higher in cancer patients than in the general population: Prevalence and severity of depressive symptoms across major cancer types. Eur. J. Cancer. 2017 Feb; 72 : 46–53. PubMed Abstract | Publisher Full Text 43. S K Wijesiri HSM, Samarasinghe K, Wasalathanthri S, et al. : Experiences of family caregivers of the older people with limitations in activities: A qualitative study. Health Soc. Care Community [Internet]. 2022 Nov; 30 (6): e6511–e6520. PubMed Abstract | Publisher Full Text 44. Schulz R, Beach SR, Czaja SJ, et al. : Family caregiving for older adults. Annu. Rev. Psychol [Internet]. 2020 Jan 4; 71 (1): 635–659. PubMed Abstract | Publisher Full Text | Free Full Text 45. Sit HF, Huang L, Chang K, et al. : Caregiving burden among informal caregivers of people with disability. Br. J. Health Psychol. 2020 Sep; 25 (3): 790–813. Publisher Full Text 46. Mlenzana NB, Eide AH, Frantz JM: Perceptions and satisfaction of caregivers regarding rehabilitation services from selected rehabilitation centres in the Western Cape. Afr. J. Disabil. 2018 Oct 25; 7 : 415. Publisher Full Text 47. Paredes-Laguna DS, Calderón-Curiñaupa WR, Soto-Nuñez SL, et al. : Factors associated with the use of rehabilitation services among people with disabilities in Chile: A population-based study. [Dataset]. figshare. 2022. Publisher Full Text Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 18 Jan 2023 ADD YOUR COMMENT Comment Author details Author details 1 School of Medicine, Faculty of Health Sciences, Universidad Científica del Sur, Lima, Peru Dania Silvia Paredes-Laguna Roles: Data Curation, Investigation, Project Administration, Resources, Writing – Original Draft Preparation William Romeo Calderón-Curiñaupa Roles: Data Curation, Investigation, Project Administration, Resources, Writing – Original Draft Preparation Sandra Liz Soto-Nuñez Roles: Investigation, Resources, Writing – Original Draft Preparation Adriana Berenice Espinoza-Hoempler Roles: Investigation, Resources, Writing – Original Draft Preparation J. Jhonnel Alarco Roles: Conceptualization, Formal Analysis, Investigation, Supervision, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (2) version 2 Revised Published: 17 Jan 2025, 12:73 https://doi.org/10.12688/f1000research.128242.2 version 1 Published: 18 Jan 2023, 12:73 https://doi.org/10.12688/f1000research.128242.1 Copyright © 2025 Paredes-Laguna DS et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Paredes-Laguna DS, Calderón-Curiñaupa WR, Soto-Nuñez SL et al. Factors associated with the use of rehabilitation services among people with disabilities in Chile: A population-based study [version 2; peer review: 4 approved with reservations] . F1000Research 2025, 12 :73 ( https://doi.org/10.12688/f1000research.128242.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 2 VERSION 2 PUBLISHED 17 Jan 2025 Revised Views 0 Cite How to cite this report: Bright T. Reviewer Report For: Factors associated with the use of rehabilitation services among people with disabilities in Chile: A population-based study [version 2; peer review: 4 approved with reservations] . F1000Research 2025, 12 :73 ( https://doi.org/10.5256/f1000research.176509.r369163 ) The direct URL for this report is: https://f1000research.com/articles/12-73/v2#referee-response-369163 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 31 Mar 2025 Tess Bright , The University of Melbourne, Melbourne, Victoria, Australia Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.176509.r369163 Q1. Some typos throughout, please check. E.g. Rehabilitation services ARE estimated to become more necessary as the population ages. Also check table formatting, some decimal places use a comma and others use a full stop. Q2. Measurement ... Continue reading READ ALL Q1. Some typos throughout, please check. E.g. Rehabilitation services ARE estimated to become more necessary as the population ages. Also check table formatting, some decimal places use a comma and others use a full stop. Q2. Measurement of disability is provided, but the definition of disability used for this study is not clear. Q4. The crude model - you state in the methods that you are using a significance level of 0.05. I agree with previous reviews that not all people with disabilities will need rehabilitation. Is there any more data in the survey that can provide an estimate of how many were in need? Also it would be interesting to know how access varied by impairment type, and whether impairment type had an influence on rehabilitation, and also degree of impairment. What types of rehabilitation were people accessing in the study? Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Partly Competing Interests: No competing interests were disclosed. Reviewer Expertise: Disability I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Bright T. Reviewer Report For: Factors associated with the use of rehabilitation services among people with disabilities in Chile: A population-based study [version 2; peer review: 4 approved with reservations] . F1000Research 2025, 12 :73 ( https://doi.org/10.5256/f1000research.176509.r369163 ) The direct URL for this report is: https://f1000research.com/articles/12-73/v2#referee-response-369163 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Kiekens C. Reviewer Report For: Factors associated with the use of rehabilitation services among people with disabilities in Chile: A population-based study [version 2; peer review: 4 approved with reservations] . F1000Research 2025, 12 :73 ( https://doi.org/10.5256/f1000research.176509.r362558 ) The direct URL for this report is: https://f1000research.com/articles/12-73/v2#referee-response-362558 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 25 Feb 2025 Carlotte Kiekens , IRCCS Istituto Ortopedico Galeazzi, Milan, Italy Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.176509.r362558 Dear authors Thank you for this interesting study and for addressing the previous reviewers' comments. Please find below my comments. Keywords: In this case, "rehabilitation" seems more appropriate than "rehabilitation research". In addition, I would suggest ... Continue reading READ ALL Dear authors Thank you for this interesting study and for addressing the previous reviewers' comments. Please find below my comments. Keywords: In this case, "rehabilitation" seems more appropriate than "rehabilitation research". In addition, I would suggest to use the MeSH terms: persons with disabilities, demography. Caregivers is OK. Abstract Methods: add data after sociodemographic Introduction Paragraph 1 - line 1: means instead of mean paragraph 3 - I fully agree with reviewer Kamonov that rehabilitation is a health strategy for people with health conditions. I appreciate you improved this part of the paper but still do not completely agree on how you formulate the definition and in particular the term "clinical". Rehabilitation, comprising all bio-psychosocial aspects remains a health strategy, aiming at improving functioning of people with disabling health conditions. In addition, functioning is now recognised as the third health indicator together with mortality and morbidity. You could also look at these papers for more info: Stucki G, et al., 2017 (Ref 1) Negrini S, et al., 2022 (Ref 2) (I disclose that I am a coauthor of this article). I see a contradiction in the country in Latin America with highest prevalence of PWDs: in paragraph 4 you mention brazil/Uruguay and in par. 6 Chile, please check and clarify. You discuss CBR largely. It is not clear to me how this comes back to your methods/results. Do I understand correctly that you inquired on the use of rehabilitation services in general, including all types: inpatient, outpatient, community-based based etc? In par. 5 you could also refer to the resolution that was unanimously adopted at WHA76: https://apps.who.int/gb/ebwha/pdf_files/WHA76/A76_R6-en.pdf Methods In your population the age group 45-54 is lacking: is this on purpose? If yes please explain why: or is it a typo and should it be 30-44 and 45-59? Measurement of disability: you still refer to the second WRD which does not exist, please delete II and add reference of the report to which you are refereing, I suppose this one: https://www.who.int/publications/i/item/9789241564182 Results: Last line first par. replace admitted with reported. Discussion Your study's data are interesting but, as noted by the previous reviewers, would need to be benchmarked with data of the whole population with disabling health conditions. We do not know from these results whether the needs were responded to as we do not know who of the PWDs had rehabilitation needs, nor which percentage of the global population had. I understand you do not have these data, but they should be stressed more explicitly in the limitations, and you could make some recommendations for future research to tackle this issue. Thank you for considering my comments. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? I cannot comment. A qualified statistician is required. Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Partly References 1. Stucki G, Bickenbach J: Functioning: the third health indicator in the health system and the key indicator for rehabilitation. Eur J Phys Rehabil Med . 2017; 53 (1): 134-138 PubMed Abstract | Publisher Full Text 2. Negrini S, Selb M, Kiekens C, Todhunter-Brown A, et al.: Rehabilitation definition for research purposes. A global stakeholders' initiative by Cochrane Rehabilitation. Eur J Phys Rehabil Med . 2022; 58 (3): 333-341 PubMed Abstract | Publisher Full Text Competing Interests: No competing interests were disclosed. Reviewer Expertise: Rehabilitation; Physical and rehabilitation medicine; EBM/P; I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Kiekens C. Reviewer Report For: Factors associated with the use of rehabilitation services among people with disabilities in Chile: A population-based study [version 2; peer review: 4 approved with reservations] . F1000Research 2025, 12 :73 ( https://doi.org/10.5256/f1000research.176509.r362558 ) The direct URL for this report is: https://f1000research.com/articles/12-73/v2#referee-response-362558 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Version 1 VERSION 1 PUBLISHED 18 Jan 2023 Views 0 Cite How to cite this report: Gandhi D. Reviewer Report For: Factors associated with the use of rehabilitation services among people with disabilities in Chile: A population-based study [version 2; peer review: 4 approved with reservations] . F1000Research 2025, 12 :73 ( https://doi.org/10.5256/f1000research.140812.r177959 ) The direct URL for this report is: https://f1000research.com/articles/12-73/v1#referee-response-177959 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 07 Jul 2023 Dorcas Gandhi , Neurology & Physiotherapy, Christian Medical College and Hospital, Ludhiana, Punjab, India; Physiotherapy, Manipal Academy of Higher Education, Manipal, Karnataka, India Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.140812.r177959 Thank you for this much needed study. And congratulations on the well described manuscript. Introduction, kindly use the updated definition of rehabilitation provided by WHO Results: Most were urban areas and ... Continue reading READ ALL Thank you for this much needed study. And congratulations on the well described manuscript. Introduction, kindly use the updated definition of rehabilitation provided by WHO Results: Most were urban areas and did not identify with indigenous population: Would this affect the interpretation of results in anyway? Please comment. Perceived discrimination with respect to? Please provide details if available. Please comment on the type of disability and correlate with rehab service use wherever possible. This would add value to the study. Is here information of the type of caregiving that influence rehab service seeking behaviour? Informal or formal caregiving? In intro and discussion, most references are old, kindly update with recent evidence Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? I cannot comment. A qualified statistician is required. Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Partly Competing Interests: No competing interests were disclosed. Reviewer Expertise: Stroke rehab, low cost stroke rehab models, technology in stroke rehab, clinical practice guidelines and protocols, tele-rehabilitation, capacity building models I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Gandhi D. Reviewer Report For: Factors associated with the use of rehabilitation services among people with disabilities in Chile: A population-based study [version 2; peer review: 4 approved with reservations] . F1000Research 2025, 12 :73 ( https://doi.org/10.5256/f1000research.140812.r177959 ) The direct URL for this report is: https://f1000research.com/articles/12-73/v1#referee-response-177959 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 17 Jan 2025 Jhonnel Alarco , School of Medicine, Faculty of Health Sciences, Universidad Científica del Sur, Lima, Peru 17 Jan 2025 Author Response Thank you for this much needed study. And congratulations on the well described manuscript. Introduction, kindly use the updated definition of rehabilitation provided by WHO Response. Thank you very ... Continue reading Thank you for this much needed study. And congratulations on the well described manuscript. Introduction, kindly use the updated definition of rehabilitation provided by WHO Response. Thank you very much for your comment. The current WHO definition of rehabilitation—"a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions in interaction with their environment"—has been included, and the bibliographic reference has been updated accordingly. Results: Most were urban areas and did not identify with indigenous population: Would this affect the interpretation of results in anyway? Please comment. Response . Thank you very much for your comment. The results are not affected. ENDISC II is a specialized, nationally representative survey, ensuring that the findings for urbanity and the non-indigenous population are consistent with those of the general population in Chile. http://www.censo2017.cl/descargas/home/sintesis-de-resultados-censo2017.pdf Perceived discrimination with respect to? Please provide details if available. Response . Thank you very much for your comment. Unfortunately, the question regarding perceived discrimination does not specify the reason for the discrimination. It is a general question that asks: “In the past 12 months, have you felt discriminated against (i.e., been prevented from doing something, bothered, or made to feel inferior)?” Please comment on the type of disability and correlate with rehab service use wherever possible. This would add value to the study. Response. Thank you very much for your comment. Unfortunately, the ENDISC II defines types of disability as permanent or long-term conditions, which are not necessarily present in all individuals with disabilities. For this reason, we are unable to include it as a variable associated with the use of rehabilitation services. Is here information of the type of caregiving that influence rehab service seeking behaviour? Informal or formal caregiving? Response. Thank you very much for your comment. Unfortunately, the ENDISC II does not provide information on the type of care received by individuals with disabilities. This limitation is acknowledged in the study. In intro and discussion, most references are old, kindly update with recent evidence Response. Thank you very much for your comment. A new bibliographic search has been conducted, and the references have been updated accordingly. The majority of the cited articles are now less than five years old. Thank you for this much needed study. And congratulations on the well described manuscript. Introduction, kindly use the updated definition of rehabilitation provided by WHO Response. Thank you very much for your comment. The current WHO definition of rehabilitation—"a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions in interaction with their environment"—has been included, and the bibliographic reference has been updated accordingly. Results: Most were urban areas and did not identify with indigenous population: Would this affect the interpretation of results in anyway? Please comment. Response . Thank you very much for your comment. The results are not affected. ENDISC II is a specialized, nationally representative survey, ensuring that the findings for urbanity and the non-indigenous population are consistent with those of the general population in Chile. http://www.censo2017.cl/descargas/home/sintesis-de-resultados-censo2017.pdf Perceived discrimination with respect to? Please provide details if available. Response . Thank you very much for your comment. Unfortunately, the question regarding perceived discrimination does not specify the reason for the discrimination. It is a general question that asks: “In the past 12 months, have you felt discriminated against (i.e., been prevented from doing something, bothered, or made to feel inferior)?” Please comment on the type of disability and correlate with rehab service use wherever possible. This would add value to the study. Response. Thank you very much for your comment. Unfortunately, the ENDISC II defines types of disability as permanent or long-term conditions, which are not necessarily present in all individuals with disabilities. For this reason, we are unable to include it as a variable associated with the use of rehabilitation services. Is here information of the type of caregiving that influence rehab service seeking behaviour? Informal or formal caregiving? Response. Thank you very much for your comment. Unfortunately, the ENDISC II does not provide information on the type of care received by individuals with disabilities. This limitation is acknowledged in the study. In intro and discussion, most references are old, kindly update with recent evidence Response. Thank you very much for your comment. A new bibliographic search has been conducted, and the references have been updated accordingly. The majority of the cited articles are now less than five years old. Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 17 Jan 2025 Jhonnel Alarco , School of Medicine, Faculty of Health Sciences, Universidad Científica del Sur, Lima, Peru 17 Jan 2025 Author Response Thank you for this much needed study. And congratulations on the well described manuscript. Introduction, kindly use the updated definition of rehabilitation provided by WHO Response. Thank you very ... Continue reading Thank you for this much needed study. And congratulations on the well described manuscript. Introduction, kindly use the updated definition of rehabilitation provided by WHO Response. Thank you very much for your comment. The current WHO definition of rehabilitation—"a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions in interaction with their environment"—has been included, and the bibliographic reference has been updated accordingly. Results: Most were urban areas and did not identify with indigenous population: Would this affect the interpretation of results in anyway? Please comment. Response . Thank you very much for your comment. The results are not affected. ENDISC II is a specialized, nationally representative survey, ensuring that the findings for urbanity and the non-indigenous population are consistent with those of the general population in Chile. http://www.censo2017.cl/descargas/home/sintesis-de-resultados-censo2017.pdf Perceived discrimination with respect to? Please provide details if available. Response . Thank you very much for your comment. Unfortunately, the question regarding perceived discrimination does not specify the reason for the discrimination. It is a general question that asks: “In the past 12 months, have you felt discriminated against (i.e., been prevented from doing something, bothered, or made to feel inferior)?” Please comment on the type of disability and correlate with rehab service use wherever possible. This would add value to the study. Response. Thank you very much for your comment. Unfortunately, the ENDISC II defines types of disability as permanent or long-term conditions, which are not necessarily present in all individuals with disabilities. For this reason, we are unable to include it as a variable associated with the use of rehabilitation services. Is here information of the type of caregiving that influence rehab service seeking behaviour? Informal or formal caregiving? Response. Thank you very much for your comment. Unfortunately, the ENDISC II does not provide information on the type of care received by individuals with disabilities. This limitation is acknowledged in the study. In intro and discussion, most references are old, kindly update with recent evidence Response. Thank you very much for your comment. A new bibliographic search has been conducted, and the references have been updated accordingly. The majority of the cited articles are now less than five years old. Thank you for this much needed study. And congratulations on the well described manuscript. Introduction, kindly use the updated definition of rehabilitation provided by WHO Response. Thank you very much for your comment. The current WHO definition of rehabilitation—"a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions in interaction with their environment"—has been included, and the bibliographic reference has been updated accordingly. Results: Most were urban areas and did not identify with indigenous population: Would this affect the interpretation of results in anyway? Please comment. Response . Thank you very much for your comment. The results are not affected. ENDISC II is a specialized, nationally representative survey, ensuring that the findings for urbanity and the non-indigenous population are consistent with those of the general population in Chile. http://www.censo2017.cl/descargas/home/sintesis-de-resultados-censo2017.pdf Perceived discrimination with respect to? Please provide details if available. Response . Thank you very much for your comment. Unfortunately, the question regarding perceived discrimination does not specify the reason for the discrimination. It is a general question that asks: “In the past 12 months, have you felt discriminated against (i.e., been prevented from doing something, bothered, or made to feel inferior)?” Please comment on the type of disability and correlate with rehab service use wherever possible. This would add value to the study. Response. Thank you very much for your comment. Unfortunately, the ENDISC II defines types of disability as permanent or long-term conditions, which are not necessarily present in all individuals with disabilities. For this reason, we are unable to include it as a variable associated with the use of rehabilitation services. Is here information of the type of caregiving that influence rehab service seeking behaviour? Informal or formal caregiving? Response. Thank you very much for your comment. Unfortunately, the ENDISC II does not provide information on the type of care received by individuals with disabilities. This limitation is acknowledged in the study. In intro and discussion, most references are old, kindly update with recent evidence Response. Thank you very much for your comment. A new bibliographic search has been conducted, and the references have been updated accordingly. The majority of the cited articles are now less than five years old. Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Kamenov K. Reviewer Report For: Factors associated with the use of rehabilitation services among people with disabilities in Chile: A population-based study [version 2; peer review: 4 approved with reservations] . F1000Research 2025, 12 :73 ( https://doi.org/10.5256/f1000research.140812.r164255 ) The direct URL for this report is: https://f1000research.com/articles/12-73/v1#referee-response-164255 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 27 Feb 2023 Kaloyan Kamenov , Sensory Functions, Disability and Rehabilitation, Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.140812.r164255 Thank you for submitting this interesting and important article. I think that the paper has its merits but will benefit from some changes and improvements, especially in the concept of rehabilitation. Here are my suggestions: One overall ... Continue reading READ ALL Thank you for submitting this interesting and important article. I think that the paper has its merits but will benefit from some changes and improvements, especially in the concept of rehabilitation. Here are my suggestions: One overall comment - I understand that the study focuses on persons with disabilities. I don't know if this is because the authors think that rehabilitation is only for persons with disabilities, or simply because you are interested in this population. If it is the first one, I would suggest you expand your scope and look at the whole population that did the survey, because rehabilitation is a service for everyone, not just persons with disabilities. You can still maybe explore whether having a disability is a factor for the use of rehabilitation, and see whether persons with disabilities experience more barriers to access. If it is the second one, the it is ok and you can leave it as it is, but you have to make sure you explain that rehabilitation is not a service exclusively for persons with disabilities. Abstract In the following sentence "Rehabilitation services are necessary for people with disabilities to improve their quality of life and be included in society", please indicate that rehabilitation is necessary for many persons with disabilities, and not for all. Not every person with a disability would need rehabilitation. Also, rehabilitation primarily improves the functioning of a person rather than quality of life, so I would either replace quality of life with functioning, or use both. Introduction The definition of rehabilitation provided is not correct. WHO has moved from this definition for years. Please, use the new definition, provided here: https://www.who.int/news-room/fact-sheets/detail/rehabilitation It is important to make the distinction between rehabilitation and disability - rehabilitation is a service for anyone - with or without a disability, and the other way around - many people with disabilities will require rehabilitation, but not all, and certainly they are not the only ones. In general, most of the references in the introduction are old. I would suggest to include more recent ones. There are a lot of systematic reviews published in the past 5 years. WHO's new estimate of prevalence of disability is 16%, according to the Global report on health equity for persons with disabilities published in 2022. While it is true that WHO introduced the CBR approach, since 2017 WHO has been promoting the Rehabilitation 2030 initiative, which focuses on the overall importance of strengthening health systems to provide rehabilitation across all levels of care, including, but not only rehabilitation provided in the communities. I understand that you are providing examples before 2015 when your data is from, but I would certainly talk about Rehabilitation 2030, and simply give the CBR example of what was done in Chile, without emphasizing the whole CBR strategy as the only thing that WHO promotes, because it is not true. In addition, do you have any other evidence of what was done in Chile after 2015? Any new initiatives, is rehabilitation part of universal health coverage? Methods In measurement of disability you say that the methodology is based on the MDS used by WHO in the II World Report on Disability, which is not true. It is based on the MDS and this is sufficient, because firstly, there is no II World Report on Disability, there is only one World Report on Disability, and second - MDS was created after the world report was published in 2011, so it cannot be included there. In addition, the MDS explores functioning, capacity (not health status), and environmental factors. Results I would also do an ad hoc or sensitivity analysis with the sample without disability and see whether there are any differences in the factors, compared to those with disabilities Discussion In the section "Prevalence of the use of rehabilitation services in people with disabilities" you are comparing your results with a systematic review on unmet needs for rehabilitation, which is not correct. Your analysis does not show gaps in the use of rehab services, because your questions does not ask that. Your question which you use as a dependent variable asks whether people with disabilities have used services, which indicates service utilization, not met or unmet needs. You don't know whether every person with a disability needs rehabilitation services? It may be that everyone who needed rehabilitation received it. The systematic review that you cite is based on questions like "did you receive rehabilitation when you needed it?" or something in this line. I would suggest you delete this section. "this would be explained by the physical and intellectual demand that is necessary to achieve a higher level of education, and because of their condition, people with disabilities would not reach this level." - this is absolutely not true. There is no study that can show that having a disability makes it too effortful for someone to study. However, there are many studies showing that environmental barriers stop people with disabilities to study - lack of accessible educational materials, infrastructure in schools, negative attitudes by teachers, etc. Please, change this statement. "The more significant disability in people with lower educational levels would explain our study’s greater need for rehabilitation services." - or maybe people with lower education don't have access to information and don't know that there are rehab services available. I am sure that if you run the same analysis with the sample of people without disability, you will find the same result. "According to our findings and the evidence reviewed, there is an increase in depressive symptoms in people who used rehabilitation services." - you used data from a cross-sectional study. How do you know that there is an increase in depressive symptoms due to the rehabilitation? You can't know that. You simply know that those who had rehabilitation also had depressive symptoms, but they may have had these symptoms already before, and maybe they don't have anything to do with the rehab process. "One of the consequences of disability is dependence on performing basic activities, which leads to the need for a caregiver" - this is not a consequence of a disability. It is simply that some people with disability, who have an underlying condition that require assistance may need a caregiver. In the paragraph on caregivers, it sounds like the persons with a disability does not have any opinion or decision, and everything depends on the caregiver, which is not true. I would soften the language and reflect the importance of persons with disabilities taking their own decisions, which, in some cases, can be taken by the caregivers in reality. "First, social desirability and recall biases could alter the prevalence of rehabilitation services in persons with disabilities." - please, explain what you mean. please, change "chronic disabilities" with chronic health conditions. The discussion has not even one sentence on the implications of this study. What do these results mean? How can these results be used to address any gaps as you mention in the abstract? How are your findings important for research and clinical practice? Please, include some thoughts on that. Conclusions "These results should guide rehabilitation professionals in identifying depressive or anxious conditions that may impair compliance and correct performance of therapies." - this doesn't make any sense. It is important, of course, that a rehab professional knows if a person has anxiety or depression, but I am not sure how will this change their intervention if someone has a physical disability? I would imagine that the person will also be treated for their depression or anxiety, but will this be done by the rehab professional? I think that more explanation is needed here. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? I cannot comment. A qualified statistician is required. Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Partly Competing Interests: No competing interests were disclosed. Reviewer Expertise: Disability, rehabilitation I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Kamenov K. Reviewer Report For: Factors associated with the use of rehabilitation services among people with disabilities in Chile: A population-based study [version 2; peer review: 4 approved with reservations] . F1000Research 2025, 12 :73 ( https://doi.org/10.5256/f1000research.140812.r164255 ) The direct URL for this report is: https://f1000research.com/articles/12-73/v1#referee-response-164255 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 17 Jan 2025 Jhonnel Alarco , School of Medicine, Faculty of Health Sciences, Universidad Científica del Sur, Lima, Peru 17 Jan 2025 Author Response Reviewer: Thank you for submitting this interesting and important article. I think that the paper has its merits but will benefit from some changes and improvements, especially in the concept ... Continue reading Reviewer: Thank you for submitting this interesting and important article. I think that the paper has its merits but will benefit from some changes and improvements, especially in the concept of rehabilitation. Here are my suggestions: One overall comment - I understand that the study focuses on persons with disabilities. I don't know if this is because the authors think that rehabilitation is only for persons with disabilities, or simply because you are interested in this population. If it is the first one, I would suggest you expand your scope and look at the whole population that did the survey, because rehabilitation is a service for everyone, not just persons with disabilities. You can still maybe explore whether having a disability is a factor for the use of rehabilitation, and see whether persons with disabilities experience more barriers to access. If it is the second one, the it is ok and you can leave it as it is, but you have to make sure you explain that rehabilitation is not a service exclusively for persons with disabilities. Response . Thank you very much for your comment. Indeed, this study focuses exclusively on individuals with disabilities. However, we find the suggestion to evaluate whether having a disability serves as a predictor for the use of rehabilitation services to be highly insightful. In future studies where disability is analyzed as an outcome, we will consider incorporating this variable. Additionally, we have clarified that rehabilitation services are not exclusively intended for individuals with disabilities. Reviewer: Abstract In the following sentence "Rehabilitation services are necessary for people with disabilities to improve their quality of life and be included in society", please indicate that rehabilitation is necessary for many persons with disabilities, and not for all. Not every person with a disability would need rehabilitation. Also, rehabilitation primarily improves the functioning of a person rather than quality of life, so I would either replace quality of life with functioning, or use both. Response . Thank you very much for your comment; we completely agree. The sentence has been revised to state: "Rehabilitation services are necessary for many people with disabilities to improve their functioning and be included in society". Reviewer: Introduction The definition of rehabilitation provided is not correct. WHO has moved from this definition for years. Please, use the new definition, provided here: https://www.who.int/news-room/fact-sheets/detail/rehabilitation Response . Thank you very much for your comment. The new WHO definition of rehabilitation “a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions in interaction with their environment” has been added and the bibliographic reference has been updated. Reviewer: It is important to make the distinction between rehabilitation and disability - rehabilitation is a service for anyone - with or without a disability, and the other way around - many people with disabilities will require rehabilitation, but not all, and certainly they are not the only ones. Response . Thank you very much for your comment. A distinction has been made between rehabilitation and disability, emphasizing that not all individuals with disabilities require rehabilitation. Reviewer: ​​​​​​​In general, most of the references in the introduction are old. I would suggest to include more recent ones. There are a lot of systematic reviews published in the past 5 years. Response . Thank you very much for your comment. A new bibliographic search has been conducted, and the references have been updated accordingly. The majority of the cited articles are now less than five years old. Reviewer: ​​​​​​​WHO's new estimate of prevalence of disability is 16%, according to the Global report on health equity for persons with disabilities published in 2022. Response . Thank you very much for your comment; we agree. The global prevalence of disability has been updated to 16%, as reported in the 2022 Global Report on Health Equity for Persons with Disabilities. Reviewer: ​​​​​​​While it is true that WHO introduced the CBR approach, since 2017 WHO has been promoting the Rehabilitation 2030 initiative, which focuses on the overall importance of strengthening health systems to provide rehabilitation across all levels of care, including, but not only rehabilitation provided in the communities. I understand that you are providing examples before 2015 when your data is from, but I would certainly talk about Rehabilitation 2030, and simply give the CBR example of what was done in Chile, without emphasizing the whole CBR strategy as the only thing that WHO promotes, because it is not true. In addition, do you have any other evidence of what was done in Chile after 2015? Any new initiatives, is rehabilitation part of universal health coverage? Response . Thank you very much for your comment. We have revised the section discussing Community-Based Rehabilitation (CBR), placing greater emphasis on the Rehabilitation 2030 initiative and including examples of actions implemented in Chile after 2015. Reviewer: Methods In measurement of disability you say that the methodology is based on the MDS used by WHO in the II World Report on Disability, which is not true. It is based on the MDS and this is sufficient, because firstly, there is no II World Report on Disability, there is only one World Report on Disability, and second - MDS was created after the world report was published in 2011, so it cannot be included there. In addition, the MDS explores functioning, capacity (not health status), and environmental factors. Response . Thank you very much for your comment; we agree and regret the error. The information regarding the MDS has been corrected to indicate that it examines functioning, capacity, and environmental factors. Reviewer: Results I would also do an ad hoc or sensitivity analysis with the sample without disability and see whether there are any differences in the factors, compared to those with disabilities Response . Thank you very much for your comment; however, we respectfully disagree. This analysis focuses exclusively on the population with disabilities. Comparing the associated factors between individuals with and without disabilities falls outside the scope of the study's objectives. Reviewer: Discussion In the section "Prevalence of the use of rehabilitation services in people with disabilities" you are comparing your results with a systematic review on unmet needs for rehabilitation, which is not correct. Your analysis does not show gaps in the use of rehab services, because your questions does not ask that. Your question which you use as a dependent variable asks whether people with disabilities have used services, which indicates service utilization, not met or unmet needs. You don't know whether every person with a disability needs rehabilitation services? It may be that everyone who needed rehabilitation received it. The systematic review that you cite is based on questions like "did you receive rehabilitation when you needed it?" or something in this line. I would suggest you delete this section. Response . Thank you very much for your comment; we agree. We have decided to exclude this systematic review from the discussion. Reviewer: "this would be explained by the physical and intellectual demand that is necessary to achieve a higher level of education, and because of their condition, people with disabilities would not reach this level." - this is absolutely not true. There is no study that can show that having a disability makes it too effortful for someone to study. However, there are many studies showing that environmental barriers stop people with disabilities to study - lack of accessible educational materials, infrastructure in schools, negative attitudes by teachers, etc. Please, change this statement. Response . Thank you very much for your comment; we agree. This statement has been revised to emphasize environmental barriers as a primary factor contributing to the lack of access to education for individuals with disabilities. Reviewer: "The more significant disability in people with lower educational levels would explain our study’s greater need for rehabilitation services." - or maybe people with lower education don't have access to information and don't know that there are rehab services available. I am sure that if you run the same analysis with the sample of people without disability, you will find the same result. Response . Thank you very much for your comment. Both explanations have been included. Unfortunately, we do not have data on the use of rehabilitation services among individuals without disabilities. Therefore, we cannot conclude that lower educational attainment increases the use of rehabilitation services in this group. Reviewer: "According to our findings and the evidence reviewed, there is an increase in depressive symptoms in people who used rehabilitation services." - you used data from a cross-sectional study. How do you know that there is an increase in depressive symptoms due to the rehabilitation? You can't know that. You simply know that those who had rehabilitation also had depressive symptoms, but they may have had these symptoms already before, and maybe they don't have anything to do with the rehab process. Response . Thank you very much for your comment; we agree. The wording has been revised accordingly. Reviewer: "One of the consequences of disability is dependence on performing basic activities, which leads to the need for a caregiver" - this is not a consequence of a disability. It is simply that some people with disability, who have an underlying condition that require assistance may need a caregiver. Response . Thank you very much for your comment; we agree. The wording has been revised accordingly. Reviewer: In the paragraph on caregivers, it sounds like the persons with a disability does not have any opinion or decision, and everything depends on the caregiver, which is not true. I would soften the language and reflect the importance of persons with disabilities taking their own decisions, which, in some cases, can be taken by the caregivers in reality. Response . Thank you very much for your comment; we agree. We have ensured that the wording appropriately emphasizes the importance of individuals with disabilities making their own decisions. Reviewer: "First, social desirability and recall biases could alter the prevalence of rehabilitation services in persons with disabilities." - please, explain what you mean. Response . Thank you very much for your comment. The wording has been revised, and the explanation of social desirability and recall biases has been clarified and improved. Reviewer: please, change "chronic disabilities" with chronic health conditions. Response . Thank you very much for your comment. The term has been corrected. The discussion has not even one sentence on the implications of this study. What do these results mean? How can these results be used to address any gaps as you mention in the abstract? How are your findings important for research and clinical practice? Please, include some thoughts on that. Response . Thank you very much for your comment. A section is added to discuss the implications of the findings for public health in Chile. Reviewer: Conclusions "These results should guide rehabilitation professionals in identifying depressive or anxious conditions that may impair compliance and correct performance of therapies." - this doesn't make any sense. It is important, of course, that a rehab professional knows if a person has anxiety or depression, but I am not sure how will this change their intervention if someone has a physical disability? I would imagine that the person will also be treated for their depression or anxiety, but will this be done by the rehab professional? I think that more explanation is needed here. Response . Thank you very much for your comment. The conclusions have been revised to specify that health professionals, not exclusively rehabilitation professionals, should identify depressive or anxious conditions. Reviewer: Thank you for submitting this interesting and important article. I think that the paper has its merits but will benefit from some changes and improvements, especially in the concept of rehabilitation. Here are my suggestions: One overall comment - I understand that the study focuses on persons with disabilities. I don't know if this is because the authors think that rehabilitation is only for persons with disabilities, or simply because you are interested in this population. If it is the first one, I would suggest you expand your scope and look at the whole population that did the survey, because rehabilitation is a service for everyone, not just persons with disabilities. You can still maybe explore whether having a disability is a factor for the use of rehabilitation, and see whether persons with disabilities experience more barriers to access. If it is the second one, the it is ok and you can leave it as it is, but you have to make sure you explain that rehabilitation is not a service exclusively for persons with disabilities. Response . Thank you very much for your comment. Indeed, this study focuses exclusively on individuals with disabilities. However, we find the suggestion to evaluate whether having a disability serves as a predictor for the use of rehabilitation services to be highly insightful. In future studies where disability is analyzed as an outcome, we will consider incorporating this variable. Additionally, we have clarified that rehabilitation services are not exclusively intended for individuals with disabilities. Reviewer: Abstract In the following sentence "Rehabilitation services are necessary for people with disabilities to improve their quality of life and be included in society", please indicate that rehabilitation is necessary for many persons with disabilities, and not for all. Not every person with a disability would need rehabilitation. Also, rehabilitation primarily improves the functioning of a person rather than quality of life, so I would either replace quality of life with functioning, or use both. Response . Thank you very much for your comment; we completely agree. The sentence has been revised to state: "Rehabilitation services are necessary for many people with disabilities to improve their functioning and be included in society". Reviewer: Introduction The definition of rehabilitation provided is not correct. WHO has moved from this definition for years. Please, use the new definition, provided here: https://www.who.int/news-room/fact-sheets/detail/rehabilitation Response . Thank you very much for your comment. The new WHO definition of rehabilitation “a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions in interaction with their environment” has been added and the bibliographic reference has been updated. Reviewer: It is important to make the distinction between rehabilitation and disability - rehabilitation is a service for anyone - with or without a disability, and the other way around - many people with disabilities will require rehabilitation, but not all, and certainly they are not the only ones. Response . Thank you very much for your comment. A distinction has been made between rehabilitation and disability, emphasizing that not all individuals with disabilities require rehabilitation. Reviewer: ​​​​​​​In general, most of the references in the introduction are old. I would suggest to include more recent ones. There are a lot of systematic reviews published in the past 5 years. Response . Thank you very much for your comment. A new bibliographic search has been conducted, and the references have been updated accordingly. The majority of the cited articles are now less than five years old. Reviewer: ​​​​​​​WHO's new estimate of prevalence of disability is 16%, according to the Global report on health equity for persons with disabilities published in 2022. Response . Thank you very much for your comment; we agree. The global prevalence of disability has been updated to 16%, as reported in the 2022 Global Report on Health Equity for Persons with Disabilities. Reviewer: ​​​​​​​While it is true that WHO introduced the CBR approach, since 2017 WHO has been promoting the Rehabilitation 2030 initiative, which focuses on the overall importance of strengthening health systems to provide rehabilitation across all levels of care, including, but not only rehabilitation provided in the communities. I understand that you are providing examples before 2015 when your data is from, but I would certainly talk about Rehabilitation 2030, and simply give the CBR example of what was done in Chile, without emphasizing the whole CBR strategy as the only thing that WHO promotes, because it is not true. In addition, do you have any other evidence of what was done in Chile after 2015? Any new initiatives, is rehabilitation part of universal health coverage? Response . Thank you very much for your comment. We have revised the section discussing Community-Based Rehabilitation (CBR), placing greater emphasis on the Rehabilitation 2030 initiative and including examples of actions implemented in Chile after 2015. Reviewer: Methods In measurement of disability you say that the methodology is based on the MDS used by WHO in the II World Report on Disability, which is not true. It is based on the MDS and this is sufficient, because firstly, there is no II World Report on Disability, there is only one World Report on Disability, and second - MDS was created after the world report was published in 2011, so it cannot be included there. In addition, the MDS explores functioning, capacity (not health status), and environmental factors. Response . Thank you very much for your comment; we agree and regret the error. The information regarding the MDS has been corrected to indicate that it examines functioning, capacity, and environmental factors. Reviewer: Results I would also do an ad hoc or sensitivity analysis with the sample without disability and see whether there are any differences in the factors, compared to those with disabilities Response . Thank you very much for your comment; however, we respectfully disagree. This analysis focuses exclusively on the population with disabilities. Comparing the associated factors between individuals with and without disabilities falls outside the scope of the study's objectives. Reviewer: Discussion In the section "Prevalence of the use of rehabilitation services in people with disabilities" you are comparing your results with a systematic review on unmet needs for rehabilitation, which is not correct. Your analysis does not show gaps in the use of rehab services, because your questions does not ask that. Your question which you use as a dependent variable asks whether people with disabilities have used services, which indicates service utilization, not met or unmet needs. You don't know whether every person with a disability needs rehabilitation services? It may be that everyone who needed rehabilitation received it. The systematic review that you cite is based on questions like "did you receive rehabilitation when you needed it?" or something in this line. I would suggest you delete this section. Response . Thank you very much for your comment; we agree. We have decided to exclude this systematic review from the discussion. Reviewer: "this would be explained by the physical and intellectual demand that is necessary to achieve a higher level of education, and because of their condition, people with disabilities would not reach this level." - this is absolutely not true. There is no study that can show that having a disability makes it too effortful for someone to study. However, there are many studies showing that environmental barriers stop people with disabilities to study - lack of accessible educational materials, infrastructure in schools, negative attitudes by teachers, etc. Please, change this statement. Response . Thank you very much for your comment; we agree. This statement has been revised to emphasize environmental barriers as a primary factor contributing to the lack of access to education for individuals with disabilities. Reviewer: "The more significant disability in people with lower educational levels would explain our study’s greater need for rehabilitation services." - or maybe people with lower education don't have access to information and don't know that there are rehab services available. I am sure that if you run the same analysis with the sample of people without disability, you will find the same result. Response . Thank you very much for your comment. Both explanations have been included. Unfortunately, we do not have data on the use of rehabilitation services among individuals without disabilities. Therefore, we cannot conclude that lower educational attainment increases the use of rehabilitation services in this group. Reviewer: "According to our findings and the evidence reviewed, there is an increase in depressive symptoms in people who used rehabilitation services." - you used data from a cross-sectional study. How do you know that there is an increase in depressive symptoms due to the rehabilitation? You can't know that. You simply know that those who had rehabilitation also had depressive symptoms, but they may have had these symptoms already before, and maybe they don't have anything to do with the rehab process. Response . Thank you very much for your comment; we agree. The wording has been revised accordingly. Reviewer: "One of the consequences of disability is dependence on performing basic activities, which leads to the need for a caregiver" - this is not a consequence of a disability. It is simply that some people with disability, who have an underlying condition that require assistance may need a caregiver. Response . Thank you very much for your comment; we agree. The wording has been revised accordingly. Reviewer: In the paragraph on caregivers, it sounds like the persons with a disability does not have any opinion or decision, and everything depends on the caregiver, which is not true. I would soften the language and reflect the importance of persons with disabilities taking their own decisions, which, in some cases, can be taken by the caregivers in reality. Response . Thank you very much for your comment; we agree. We have ensured that the wording appropriately emphasizes the importance of individuals with disabilities making their own decisions. Reviewer: "First, social desirability and recall biases could alter the prevalence of rehabilitation services in persons with disabilities." - please, explain what you mean. Response . Thank you very much for your comment. The wording has been revised, and the explanation of social desirability and recall biases has been clarified and improved. Reviewer: please, change "chronic disabilities" with chronic health conditions. Response . Thank you very much for your comment. The term has been corrected. The discussion has not even one sentence on the implications of this study. What do these results mean? How can these results be used to address any gaps as you mention in the abstract? How are your findings important for research and clinical practice? Please, include some thoughts on that. Response . Thank you very much for your comment. A section is added to discuss the implications of the findings for public health in Chile. Reviewer: Conclusions "These results should guide rehabilitation professionals in identifying depressive or anxious conditions that may impair compliance and correct performance of therapies." - this doesn't make any sense. It is important, of course, that a rehab professional knows if a person has anxiety or depression, but I am not sure how will this change their intervention if someone has a physical disability? I would imagine that the person will also be treated for their depression or anxiety, but will this be done by the rehab professional? I think that more explanation is needed here. Response . Thank you very much for your comment. The conclusions have been revised to specify that health professionals, not exclusively rehabilitation professionals, should identify depressive or anxious conditions. Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 17 Jan 2025 Jhonnel Alarco , School of Medicine, Faculty of Health Sciences, Universidad Científica del Sur, Lima, Peru 17 Jan 2025 Author Response Reviewer: Thank you for submitting this interesting and important article. I think that the paper has its merits but will benefit from some changes and improvements, especially in the concept ... Continue reading Reviewer: Thank you for submitting this interesting and important article. I think that the paper has its merits but will benefit from some changes and improvements, especially in the concept of rehabilitation. Here are my suggestions: One overall comment - I understand that the study focuses on persons with disabilities. I don't know if this is because the authors think that rehabilitation is only for persons with disabilities, or simply because you are interested in this population. If it is the first one, I would suggest you expand your scope and look at the whole population that did the survey, because rehabilitation is a service for everyone, not just persons with disabilities. You can still maybe explore whether having a disability is a factor for the use of rehabilitation, and see whether persons with disabilities experience more barriers to access. If it is the second one, the it is ok and you can leave it as it is, but you have to make sure you explain that rehabilitation is not a service exclusively for persons with disabilities. Response . Thank you very much for your comment. Indeed, this study focuses exclusively on individuals with disabilities. However, we find the suggestion to evaluate whether having a disability serves as a predictor for the use of rehabilitation services to be highly insightful. In future studies where disability is analyzed as an outcome, we will consider incorporating this variable. Additionally, we have clarified that rehabilitation services are not exclusively intended for individuals with disabilities. Reviewer: Abstract In the following sentence "Rehabilitation services are necessary for people with disabilities to improve their quality of life and be included in society", please indicate that rehabilitation is necessary for many persons with disabilities, and not for all. Not every person with a disability would need rehabilitation. Also, rehabilitation primarily improves the functioning of a person rather than quality of life, so I would either replace quality of life with functioning, or use both. Response . Thank you very much for your comment; we completely agree. The sentence has been revised to state: "Rehabilitation services are necessary for many people with disabilities to improve their functioning and be included in society". Reviewer: Introduction The definition of rehabilitation provided is not correct. WHO has moved from this definition for years. Please, use the new definition, provided here: https://www.who.int/news-room/fact-sheets/detail/rehabilitation Response . Thank you very much for your comment. The new WHO definition of rehabilitation “a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions in interaction with their environment” has been added and the bibliographic reference has been updated. Reviewer: It is important to make the distinction between rehabilitation and disability - rehabilitation is a service for anyone - with or without a disability, and the other way around - many people with disabilities will require rehabilitation, but not all, and certainly they are not the only ones. Response . Thank you very much for your comment. A distinction has been made between rehabilitation and disability, emphasizing that not all individuals with disabilities require rehabilitation. Reviewer: ​​​​​​​In general, most of the references in the introduction are old. I would suggest to include more recent ones. There are a lot of systematic reviews published in the past 5 years. Response . Thank you very much for your comment. A new bibliographic search has been conducted, and the references have been updated accordingly. The majority of the cited articles are now less than five years old. Reviewer: ​​​​​​​WHO's new estimate of prevalence of disability is 16%, according to the Global report on health equity for persons with disabilities published in 2022. Response . Thank you very much for your comment; we agree. The global prevalence of disability has been updated to 16%, as reported in the 2022 Global Report on Health Equity for Persons with Disabilities. Reviewer: ​​​​​​​While it is true that WHO introduced the CBR approach, since 2017 WHO has been promoting the Rehabilitation 2030 initiative, which focuses on the overall importance of strengthening health systems to provide rehabilitation across all levels of care, including, but not only rehabilitation provided in the communities. I understand that you are providing examples before 2015 when your data is from, but I would certainly talk about Rehabilitation 2030, and simply give the CBR example of what was done in Chile, without emphasizing the whole CBR strategy as the only thing that WHO promotes, because it is not true. In addition, do you have any other evidence of what was done in Chile after 2015? Any new initiatives, is rehabilitation part of universal health coverage? Response . Thank you very much for your comment. We have revised the section discussing Community-Based Rehabilitation (CBR), placing greater emphasis on the Rehabilitation 2030 initiative and including examples of actions implemented in Chile after 2015. Reviewer: Methods In measurement of disability you say that the methodology is based on the MDS used by WHO in the II World Report on Disability, which is not true. It is based on the MDS and this is sufficient, because firstly, there is no II World Report on Disability, there is only one World Report on Disability, and second - MDS was created after the world report was published in 2011, so it cannot be included there. In addition, the MDS explores functioning, capacity (not health status), and environmental factors. Response . Thank you very much for your comment; we agree and regret the error. The information regarding the MDS has been corrected to indicate that it examines functioning, capacity, and environmental factors. Reviewer: Results I would also do an ad hoc or sensitivity analysis with the sample without disability and see whether there are any differences in the factors, compared to those with disabilities Response . Thank you very much for your comment; however, we respectfully disagree. This analysis focuses exclusively on the population with disabilities. Comparing the associated factors between individuals with and without disabilities falls outside the scope of the study's objectives. Reviewer: Discussion In the section "Prevalence of the use of rehabilitation services in people with disabilities" you are comparing your results with a systematic review on unmet needs for rehabilitation, which is not correct. Your analysis does not show gaps in the use of rehab services, because your questions does not ask that. Your question which you use as a dependent variable asks whether people with disabilities have used services, which indicates service utilization, not met or unmet needs. You don't know whether every person with a disability needs rehabilitation services? It may be that everyone who needed rehabilitation received it. The systematic review that you cite is based on questions like "did you receive rehabilitation when you needed it?" or something in this line. I would suggest you delete this section. Response . Thank you very much for your comment; we agree. We have decided to exclude this systematic review from the discussion. Reviewer: "this would be explained by the physical and intellectual demand that is necessary to achieve a higher level of education, and because of their condition, people with disabilities would not reach this level." - this is absolutely not true. There is no study that can show that having a disability makes it too effortful for someone to study. However, there are many studies showing that environmental barriers stop people with disabilities to study - lack of accessible educational materials, infrastructure in schools, negative attitudes by teachers, etc. Please, change this statement. Response . Thank you very much for your comment; we agree. This statement has been revised to emphasize environmental barriers as a primary factor contributing to the lack of access to education for individuals with disabilities. Reviewer: "The more significant disability in people with lower educational levels would explain our study’s greater need for rehabilitation services." - or maybe people with lower education don't have access to information and don't know that there are rehab services available. I am sure that if you run the same analysis with the sample of people without disability, you will find the same result. Response . Thank you very much for your comment. Both explanations have been included. Unfortunately, we do not have data on the use of rehabilitation services among individuals without disabilities. Therefore, we cannot conclude that lower educational attainment increases the use of rehabilitation services in this group. Reviewer: "According to our findings and the evidence reviewed, there is an increase in depressive symptoms in people who used rehabilitation services." - you used data from a cross-sectional study. How do you know that there is an increase in depressive symptoms due to the rehabilitation? You can't know that. You simply know that those who had rehabilitation also had depressive symptoms, but they may have had these symptoms already before, and maybe they don't have anything to do with the rehab process. Response . Thank you very much for your comment; we agree. The wording has been revised accordingly. Reviewer: "One of the consequences of disability is dependence on performing basic activities, which leads to the need for a caregiver" - this is not a consequence of a disability. It is simply that some people with disability, who have an underlying condition that require assistance may need a caregiver. Response . Thank you very much for your comment; we agree. The wording has been revised accordingly. Reviewer: In the paragraph on caregivers, it sounds like the persons with a disability does not have any opinion or decision, and everything depends on the caregiver, which is not true. I would soften the language and reflect the importance of persons with disabilities taking their own decisions, which, in some cases, can be taken by the caregivers in reality. Response . Thank you very much for your comment; we agree. We have ensured that the wording appropriately emphasizes the importance of individuals with disabilities making their own decisions. Reviewer: "First, social desirability and recall biases could alter the prevalence of rehabilitation services in persons with disabilities." - please, explain what you mean. Response . Thank you very much for your comment. The wording has been revised, and the explanation of social desirability and recall biases has been clarified and improved. Reviewer: please, change "chronic disabilities" with chronic health conditions. Response . Thank you very much for your comment. The term has been corrected. The discussion has not even one sentence on the implications of this study. What do these results mean? How can these results be used to address any gaps as you mention in the abstract? How are your findings important for research and clinical practice? Please, include some thoughts on that. Response . Thank you very much for your comment. A section is added to discuss the implications of the findings for public health in Chile. Reviewer: Conclusions "These results should guide rehabilitation professionals in identifying depressive or anxious conditions that may impair compliance and correct performance of therapies." - this doesn't make any sense. It is important, of course, that a rehab professional knows if a person has anxiety or depression, but I am not sure how will this change their intervention if someone has a physical disability? I would imagine that the person will also be treated for their depression or anxiety, but will this be done by the rehab professional? I think that more explanation is needed here. Response . Thank you very much for your comment. The conclusions have been revised to specify that health professionals, not exclusively rehabilitation professionals, should identify depressive or anxious conditions. Reviewer: Thank you for submitting this interesting and important article. I think that the paper has its merits but will benefit from some changes and improvements, especially in the concept of rehabilitation. Here are my suggestions: One overall comment - I understand that the study focuses on persons with disabilities. I don't know if this is because the authors think that rehabilitation is only for persons with disabilities, or simply because you are interested in this population. If it is the first one, I would suggest you expand your scope and look at the whole population that did the survey, because rehabilitation is a service for everyone, not just persons with disabilities. You can still maybe explore whether having a disability is a factor for the use of rehabilitation, and see whether persons with disabilities experience more barriers to access. If it is the second one, the it is ok and you can leave it as it is, but you have to make sure you explain that rehabilitation is not a service exclusively for persons with disabilities. Response . Thank you very much for your comment. Indeed, this study focuses exclusively on individuals with disabilities. However, we find the suggestion to evaluate whether having a disability serves as a predictor for the use of rehabilitation services to be highly insightful. In future studies where disability is analyzed as an outcome, we will consider incorporating this variable. Additionally, we have clarified that rehabilitation services are not exclusively intended for individuals with disabilities. Reviewer: Abstract In the following sentence "Rehabilitation services are necessary for people with disabilities to improve their quality of life and be included in society", please indicate that rehabilitation is necessary for many persons with disabilities, and not for all. Not every person with a disability would need rehabilitation. Also, rehabilitation primarily improves the functioning of a person rather than quality of life, so I would either replace quality of life with functioning, or use both. Response . Thank you very much for your comment; we completely agree. The sentence has been revised to state: "Rehabilitation services are necessary for many people with disabilities to improve their functioning and be included in society". Reviewer: Introduction The definition of rehabilitation provided is not correct. WHO has moved from this definition for years. Please, use the new definition, provided here: https://www.who.int/news-room/fact-sheets/detail/rehabilitation Response . Thank you very much for your comment. The new WHO definition of rehabilitation “a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions in interaction with their environment” has been added and the bibliographic reference has been updated. Reviewer: It is important to make the distinction between rehabilitation and disability - rehabilitation is a service for anyone - with or without a disability, and the other way around - many people with disabilities will require rehabilitation, but not all, and certainly they are not the only ones. Response . Thank you very much for your comment. A distinction has been made between rehabilitation and disability, emphasizing that not all individuals with disabilities require rehabilitation. Reviewer: ​​​​​​​In general, most of the references in the introduction are old. I would suggest to include more recent ones. There are a lot of systematic reviews published in the past 5 years. Response . Thank you very much for your comment. A new bibliographic search has been conducted, and the references have been updated accordingly. The majority of the cited articles are now less than five years old. Reviewer: ​​​​​​​WHO's new estimate of prevalence of disability is 16%, according to the Global report on health equity for persons with disabilities published in 2022. Response . Thank you very much for your comment; we agree. The global prevalence of disability has been updated to 16%, as reported in the 2022 Global Report on Health Equity for Persons with Disabilities. Reviewer: ​​​​​​​While it is true that WHO introduced the CBR approach, since 2017 WHO has been promoting the Rehabilitation 2030 initiative, which focuses on the overall importance of strengthening health systems to provide rehabilitation across all levels of care, including, but not only rehabilitation provided in the communities. I understand that you are providing examples before 2015 when your data is from, but I would certainly talk about Rehabilitation 2030, and simply give the CBR example of what was done in Chile, without emphasizing the whole CBR strategy as the only thing that WHO promotes, because it is not true. In addition, do you have any other evidence of what was done in Chile after 2015? Any new initiatives, is rehabilitation part of universal health coverage? Response . Thank you very much for your comment. We have revised the section discussing Community-Based Rehabilitation (CBR), placing greater emphasis on the Rehabilitation 2030 initiative and including examples of actions implemented in Chile after 2015. Reviewer: Methods In measurement of disability you say that the methodology is based on the MDS used by WHO in the II World Report on Disability, which is not true. It is based on the MDS and this is sufficient, because firstly, there is no II World Report on Disability, there is only one World Report on Disability, and second - MDS was created after the world report was published in 2011, so it cannot be included there. In addition, the MDS explores functioning, capacity (not health status), and environmental factors. Response . Thank you very much for your comment; we agree and regret the error. The information regarding the MDS has been corrected to indicate that it examines functioning, capacity, and environmental factors. Reviewer: Results I would also do an ad hoc or sensitivity analysis with the sample without disability and see whether there are any differences in the factors, compared to those with disabilities Response . Thank you very much for your comment; however, we respectfully disagree. This analysis focuses exclusively on the population with disabilities. Comparing the associated factors between individuals with and without disabilities falls outside the scope of the study's objectives. Reviewer: Discussion In the section "Prevalence of the use of rehabilitation services in people with disabilities" you are comparing your results with a systematic review on unmet needs for rehabilitation, which is not correct. Your analysis does not show gaps in the use of rehab services, because your questions does not ask that. Your question which you use as a dependent variable asks whether people with disabilities have used services, which indicates service utilization, not met or unmet needs. You don't know whether every person with a disability needs rehabilitation services? It may be that everyone who needed rehabilitation received it. The systematic review that you cite is based on questions like "did you receive rehabilitation when you needed it?" or something in this line. I would suggest you delete this section. Response . Thank you very much for your comment; we agree. We have decided to exclude this systematic review from the discussion. Reviewer: "this would be explained by the physical and intellectual demand that is necessary to achieve a higher level of education, and because of their condition, people with disabilities would not reach this level." - this is absolutely not true. There is no study that can show that having a disability makes it too effortful for someone to study. However, there are many studies showing that environmental barriers stop people with disabilities to study - lack of accessible educational materials, infrastructure in schools, negative attitudes by teachers, etc. Please, change this statement. Response . Thank you very much for your comment; we agree. This statement has been revised to emphasize environmental barriers as a primary factor contributing to the lack of access to education for individuals with disabilities. Reviewer: "The more significant disability in people with lower educational levels would explain our study’s greater need for rehabilitation services." - or maybe people with lower education don't have access to information and don't know that there are rehab services available. I am sure that if you run the same analysis with the sample of people without disability, you will find the same result. Response . Thank you very much for your comment. Both explanations have been included. Unfortunately, we do not have data on the use of rehabilitation services among individuals without disabilities. Therefore, we cannot conclude that lower educational attainment increases the use of rehabilitation services in this group. Reviewer: "According to our findings and the evidence reviewed, there is an increase in depressive symptoms in people who used rehabilitation services." - you used data from a cross-sectional study. How do you know that there is an increase in depressive symptoms due to the rehabilitation? You can't know that. You simply know that those who had rehabilitation also had depressive symptoms, but they may have had these symptoms already before, and maybe they don't have anything to do with the rehab process. Response . Thank you very much for your comment; we agree. The wording has been revised accordingly. Reviewer: "One of the consequences of disability is dependence on performing basic activities, which leads to the need for a caregiver" - this is not a consequence of a disability. It is simply that some people with disability, who have an underlying condition that require assistance may need a caregiver. Response . Thank you very much for your comment; we agree. The wording has been revised accordingly. Reviewer: In the paragraph on caregivers, it sounds like the persons with a disability does not have any opinion or decision, and everything depends on the caregiver, which is not true. I would soften the language and reflect the importance of persons with disabilities taking their own decisions, which, in some cases, can be taken by the caregivers in reality. Response . Thank you very much for your comment; we agree. We have ensured that the wording appropriately emphasizes the importance of individuals with disabilities making their own decisions. Reviewer: "First, social desirability and recall biases could alter the prevalence of rehabilitation services in persons with disabilities." - please, explain what you mean. Response . Thank you very much for your comment. The wording has been revised, and the explanation of social desirability and recall biases has been clarified and improved. Reviewer: please, change "chronic disabilities" with chronic health conditions. Response . Thank you very much for your comment. The term has been corrected. The discussion has not even one sentence on the implications of this study. What do these results mean? How can these results be used to address any gaps as you mention in the abstract? How are your findings important for research and clinical practice? Please, include some thoughts on that. Response . Thank you very much for your comment. A section is added to discuss the implications of the findings for public health in Chile. Reviewer: Conclusions "These results should guide rehabilitation professionals in identifying depressive or anxious conditions that may impair compliance and correct performance of therapies." - this doesn't make any sense. It is important, of course, that a rehab professional knows if a person has anxiety or depression, but I am not sure how will this change their intervention if someone has a physical disability? I would imagine that the person will also be treated for their depression or anxiety, but will this be done by the rehab professional? I think that more explanation is needed here. Response . Thank you very much for your comment. The conclusions have been revised to specify that health professionals, not exclusively rehabilitation professionals, should identify depressive or anxious conditions. Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 18 Jan 2023 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 3 4 Version 2 (revision) 17 Jan 25 read read Version 1 18 Jan 23 read read Kaloyan Kamenov , World Health Organization, Geneva, Switzerland Dorcas Gandhi , Christian Medical College and Hospital, Ludhiana, Punjab, India; Manipal Academy of Higher Education, Manipal, India Carlotte Kiekens , IRCCS Istituto Ortopedico Galeazzi, Milan, Italy Tess Bright , The University of Melbourne, Melbourne, Australia Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Bright T. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 31 Mar 2025 | for Version 2 Tess Bright , The University of Melbourne, Melbourne, Victoria, Australia 0 Views copyright © 2025 Bright T. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Q1. Some typos throughout, please check. E.g. Rehabilitation services ARE estimated to become more necessary as the population ages. Also check table formatting, some decimal places use a comma and others use a full stop. Q2. Measurement of disability is provided, but the definition of disability used for this study is not clear. Q4. The crude model - you state in the methods that you are using a significance level of 0.05. I agree with previous reviews that not all people with disabilities will need rehabilitation. Is there any more data in the survey that can provide an estimate of how many were in need? Also it would be interesting to know how access varied by impairment type, and whether impairment type had an influence on rehabilitation, and also degree of impairment. What types of rehabilitation were people accessing in the study? Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Partly Competing Interests No competing interests were disclosed. Reviewer Expertise Disability I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (0) Bright T. Peer Review Report For: Factors associated with the use of rehabilitation services among people with disabilities in Chile: A population-based study [version 2; peer review: 4 approved with reservations] . F1000Research 2025, 12 :73 ( https://doi.org/10.5256/f1000research.176509.r369163) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/12-73/v2#referee-response-369163 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Kiekens C. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 25 Feb 2025 | for Version 2 Carlotte Kiekens , IRCCS Istituto Ortopedico Galeazzi, Milan, Italy 0 Views copyright © 2025 Kiekens C. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Dear authors Thank you for this interesting study and for addressing the previous reviewers' comments. Please find below my comments. Keywords: In this case, "rehabilitation" seems more appropriate than "rehabilitation research". In addition, I would suggest to use the MeSH terms: persons with disabilities, demography. Caregivers is OK. Abstract Methods: add data after sociodemographic Introduction Paragraph 1 - line 1: means instead of mean paragraph 3 - I fully agree with reviewer Kamonov that rehabilitation is a health strategy for people with health conditions. I appreciate you improved this part of the paper but still do not completely agree on how you formulate the definition and in particular the term "clinical". Rehabilitation, comprising all bio-psychosocial aspects remains a health strategy, aiming at improving functioning of people with disabling health conditions. In addition, functioning is now recognised as the third health indicator together with mortality and morbidity. You could also look at these papers for more info: Stucki G, et al., 2017 (Ref 1) Negrini S, et al., 2022 (Ref 2) (I disclose that I am a coauthor of this article). I see a contradiction in the country in Latin America with highest prevalence of PWDs: in paragraph 4 you mention brazil/Uruguay and in par. 6 Chile, please check and clarify. You discuss CBR largely. It is not clear to me how this comes back to your methods/results. Do I understand correctly that you inquired on the use of rehabilitation services in general, including all types: inpatient, outpatient, community-based based etc? In par. 5 you could also refer to the resolution that was unanimously adopted at WHA76: https://apps.who.int/gb/ebwha/pdf_files/WHA76/A76_R6-en.pdf Methods In your population the age group 45-54 is lacking: is this on purpose? If yes please explain why: or is it a typo and should it be 30-44 and 45-59? Measurement of disability: you still refer to the second WRD which does not exist, please delete II and add reference of the report to which you are refereing, I suppose this one: https://www.who.int/publications/i/item/9789241564182 Results: Last line first par. replace admitted with reported. Discussion Your study's data are interesting but, as noted by the previous reviewers, would need to be benchmarked with data of the whole population with disabling health conditions. We do not know from these results whether the needs were responded to as we do not know who of the PWDs had rehabilitation needs, nor which percentage of the global population had. I understand you do not have these data, but they should be stressed more explicitly in the limitations, and you could make some recommendations for future research to tackle this issue. Thank you for considering my comments. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? I cannot comment. A qualified statistician is required. Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Partly References 1. Stucki G, Bickenbach J: Functioning: the third health indicator in the health system and the key indicator for rehabilitation. Eur J Phys Rehabil Med . 2017; 53 (1): 134-138 PubMed Abstract | Publisher Full Text 2. Negrini S, Selb M, Kiekens C, Todhunter-Brown A, et al.: Rehabilitation definition for research purposes. A global stakeholders' initiative by Cochrane Rehabilitation. Eur J Phys Rehabil Med . 2022; 58 (3): 333-341 PubMed Abstract | Publisher Full Text Competing Interests No competing interests were disclosed. Reviewer Expertise Rehabilitation; Physical and rehabilitation medicine; EBM/P; I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (0) Kiekens C. Peer Review Report For: Factors associated with the use of rehabilitation services among people with disabilities in Chile: A population-based study [version 2; peer review: 4 approved with reservations] . F1000Research 2025, 12 :73 ( https://doi.org/10.5256/f1000research.176509.r362558) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/12-73/v2#referee-response-362558 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2023 Gandhi D. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 07 Jul 2023 | for Version 1 Dorcas Gandhi , Neurology & Physiotherapy, Christian Medical College and Hospital, Ludhiana, Punjab, India; Physiotherapy, Manipal Academy of Higher Education, Manipal, Karnataka, India 0 Views copyright © 2023 Gandhi D. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Thank you for this much needed study. And congratulations on the well described manuscript. Introduction, kindly use the updated definition of rehabilitation provided by WHO Results: Most were urban areas and did not identify with indigenous population: Would this affect the interpretation of results in anyway? Please comment. Perceived discrimination with respect to? Please provide details if available. Please comment on the type of disability and correlate with rehab service use wherever possible. This would add value to the study. Is here information of the type of caregiving that influence rehab service seeking behaviour? Informal or formal caregiving? In intro and discussion, most references are old, kindly update with recent evidence Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? I cannot comment. A qualified statistician is required. Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Partly Competing Interests No competing interests were disclosed. Reviewer Expertise Stroke rehab, low cost stroke rehab models, technology in stroke rehab, clinical practice guidelines and protocols, tele-rehabilitation, capacity building models I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 17 Jan 2025 Jhonnel Alarco, School of Medicine, Faculty of Health Sciences, Universidad Científica del Sur, Lima, Peru Thank you for this much needed study. And congratulations on the well described manuscript. Introduction, kindly use the updated definition of rehabilitation provided by WHO Response. Thank you very much for your comment. The current WHO definition of rehabilitation—"a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions in interaction with their environment"—has been included, and the bibliographic reference has been updated accordingly. Results: Most were urban areas and did not identify with indigenous population: Would this affect the interpretation of results in anyway? Please comment. Response . Thank you very much for your comment. The results are not affected. ENDISC II is a specialized, nationally representative survey, ensuring that the findings for urbanity and the non-indigenous population are consistent with those of the general population in Chile. http://www.censo2017.cl/descargas/home/sintesis-de-resultados-censo2017.pdf Perceived discrimination with respect to? Please provide details if available. Response . Thank you very much for your comment. Unfortunately, the question regarding perceived discrimination does not specify the reason for the discrimination. It is a general question that asks: “In the past 12 months, have you felt discriminated against (i.e., been prevented from doing something, bothered, or made to feel inferior)?” Please comment on the type of disability and correlate with rehab service use wherever possible. This would add value to the study. Response. Thank you very much for your comment. Unfortunately, the ENDISC II defines types of disability as permanent or long-term conditions, which are not necessarily present in all individuals with disabilities. For this reason, we are unable to include it as a variable associated with the use of rehabilitation services. Is here information of the type of caregiving that influence rehab service seeking behaviour? Informal or formal caregiving? Response. Thank you very much for your comment. Unfortunately, the ENDISC II does not provide information on the type of care received by individuals with disabilities. This limitation is acknowledged in the study. In intro and discussion, most references are old, kindly update with recent evidence Response. Thank you very much for your comment. A new bibliographic search has been conducted, and the references have been updated accordingly. The majority of the cited articles are now less than five years old. View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Gandhi D. Peer Review Report For: Factors associated with the use of rehabilitation services among people with disabilities in Chile: A population-based study [version 2; peer review: 4 approved with reservations] . F1000Research 2025, 12 :73 ( https://doi.org/10.5256/f1000research.140812.r177959) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/12-73/v1#referee-response-177959 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2023 Kamenov K. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 27 Feb 2023 | for Version 1 Kaloyan Kamenov , Sensory Functions, Disability and Rehabilitation, Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland 0 Views copyright © 2023 Kamenov K. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Thank you for submitting this interesting and important article. I think that the paper has its merits but will benefit from some changes and improvements, especially in the concept of rehabilitation. Here are my suggestions: One overall comment - I understand that the study focuses on persons with disabilities. I don't know if this is because the authors think that rehabilitation is only for persons with disabilities, or simply because you are interested in this population. If it is the first one, I would suggest you expand your scope and look at the whole population that did the survey, because rehabilitation is a service for everyone, not just persons with disabilities. You can still maybe explore whether having a disability is a factor for the use of rehabilitation, and see whether persons with disabilities experience more barriers to access. If it is the second one, the it is ok and you can leave it as it is, but you have to make sure you explain that rehabilitation is not a service exclusively for persons with disabilities. Abstract In the following sentence "Rehabilitation services are necessary for people with disabilities to improve their quality of life and be included in society", please indicate that rehabilitation is necessary for many persons with disabilities, and not for all. Not every person with a disability would need rehabilitation. Also, rehabilitation primarily improves the functioning of a person rather than quality of life, so I would either replace quality of life with functioning, or use both. Introduction The definition of rehabilitation provided is not correct. WHO has moved from this definition for years. Please, use the new definition, provided here: https://www.who.int/news-room/fact-sheets/detail/rehabilitation It is important to make the distinction between rehabilitation and disability - rehabilitation is a service for anyone - with or without a disability, and the other way around - many people with disabilities will require rehabilitation, but not all, and certainly they are not the only ones. In general, most of the references in the introduction are old. I would suggest to include more recent ones. There are a lot of systematic reviews published in the past 5 years. WHO's new estimate of prevalence of disability is 16%, according to the Global report on health equity for persons with disabilities published in 2022. While it is true that WHO introduced the CBR approach, since 2017 WHO has been promoting the Rehabilitation 2030 initiative, which focuses on the overall importance of strengthening health systems to provide rehabilitation across all levels of care, including, but not only rehabilitation provided in the communities. I understand that you are providing examples before 2015 when your data is from, but I would certainly talk about Rehabilitation 2030, and simply give the CBR example of what was done in Chile, without emphasizing the whole CBR strategy as the only thing that WHO promotes, because it is not true. In addition, do you have any other evidence of what was done in Chile after 2015? Any new initiatives, is rehabilitation part of universal health coverage? Methods In measurement of disability you say that the methodology is based on the MDS used by WHO in the II World Report on Disability, which is not true. It is based on the MDS and this is sufficient, because firstly, there is no II World Report on Disability, there is only one World Report on Disability, and second - MDS was created after the world report was published in 2011, so it cannot be included there. In addition, the MDS explores functioning, capacity (not health status), and environmental factors. Results I would also do an ad hoc or sensitivity analysis with the sample without disability and see whether there are any differences in the factors, compared to those with disabilities Discussion In the section "Prevalence of the use of rehabilitation services in people with disabilities" you are comparing your results with a systematic review on unmet needs for rehabilitation, which is not correct. Your analysis does not show gaps in the use of rehab services, because your questions does not ask that. Your question which you use as a dependent variable asks whether people with disabilities have used services, which indicates service utilization, not met or unmet needs. You don't know whether every person with a disability needs rehabilitation services? It may be that everyone who needed rehabilitation received it. The systematic review that you cite is based on questions like "did you receive rehabilitation when you needed it?" or something in this line. I would suggest you delete this section. "this would be explained by the physical and intellectual demand that is necessary to achieve a higher level of education, and because of their condition, people with disabilities would not reach this level." - this is absolutely not true. There is no study that can show that having a disability makes it too effortful for someone to study. However, there are many studies showing that environmental barriers stop people with disabilities to study - lack of accessible educational materials, infrastructure in schools, negative attitudes by teachers, etc. Please, change this statement. "The more significant disability in people with lower educational levels would explain our study’s greater need for rehabilitation services." - or maybe people with lower education don't have access to information and don't know that there are rehab services available. I am sure that if you run the same analysis with the sample of people without disability, you will find the same result. "According to our findings and the evidence reviewed, there is an increase in depressive symptoms in people who used rehabilitation services." - you used data from a cross-sectional study. How do you know that there is an increase in depressive symptoms due to the rehabilitation? You can't know that. You simply know that those who had rehabilitation also had depressive symptoms, but they may have had these symptoms already before, and maybe they don't have anything to do with the rehab process. "One of the consequences of disability is dependence on performing basic activities, which leads to the need for a caregiver" - this is not a consequence of a disability. It is simply that some people with disability, who have an underlying condition that require assistance may need a caregiver. In the paragraph on caregivers, it sounds like the persons with a disability does not have any opinion or decision, and everything depends on the caregiver, which is not true. I would soften the language and reflect the importance of persons with disabilities taking their own decisions, which, in some cases, can be taken by the caregivers in reality. "First, social desirability and recall biases could alter the prevalence of rehabilitation services in persons with disabilities." - please, explain what you mean. please, change "chronic disabilities" with chronic health conditions. The discussion has not even one sentence on the implications of this study. What do these results mean? How can these results be used to address any gaps as you mention in the abstract? How are your findings important for research and clinical practice? Please, include some thoughts on that. Conclusions "These results should guide rehabilitation professionals in identifying depressive or anxious conditions that may impair compliance and correct performance of therapies." - this doesn't make any sense. It is important, of course, that a rehab professional knows if a person has anxiety or depression, but I am not sure how will this change their intervention if someone has a physical disability? I would imagine that the person will also be treated for their depression or anxiety, but will this be done by the rehab professional? I think that more explanation is needed here. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? I cannot comment. A qualified statistician is required. Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Partly Competing Interests No competing interests were disclosed. Reviewer Expertise Disability, rehabilitation I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 17 Jan 2025 Jhonnel Alarco, School of Medicine, Faculty of Health Sciences, Universidad Científica del Sur, Lima, Peru Reviewer: Thank you for submitting this interesting and important article. I think that the paper has its merits but will benefit from some changes and improvements, especially in the concept of rehabilitation. Here are my suggestions: One overall comment - I understand that the study focuses on persons with disabilities. I don't know if this is because the authors think that rehabilitation is only for persons with disabilities, or simply because you are interested in this population. If it is the first one, I would suggest you expand your scope and look at the whole population that did the survey, because rehabilitation is a service for everyone, not just persons with disabilities. You can still maybe explore whether having a disability is a factor for the use of rehabilitation, and see whether persons with disabilities experience more barriers to access. If it is the second one, the it is ok and you can leave it as it is, but you have to make sure you explain that rehabilitation is not a service exclusively for persons with disabilities. Response . Thank you very much for your comment. Indeed, this study focuses exclusively on individuals with disabilities. However, we find the suggestion to evaluate whether having a disability serves as a predictor for the use of rehabilitation services to be highly insightful. In future studies where disability is analyzed as an outcome, we will consider incorporating this variable. Additionally, we have clarified that rehabilitation services are not exclusively intended for individuals with disabilities. Reviewer: Abstract In the following sentence "Rehabilitation services are necessary for people with disabilities to improve their quality of life and be included in society", please indicate that rehabilitation is necessary for many persons with disabilities, and not for all. Not every person with a disability would need rehabilitation. Also, rehabilitation primarily improves the functioning of a person rather than quality of life, so I would either replace quality of life with functioning, or use both. Response . Thank you very much for your comment; we completely agree. The sentence has been revised to state: "Rehabilitation services are necessary for many people with disabilities to improve their functioning and be included in society". Reviewer: Introduction The definition of rehabilitation provided is not correct. WHO has moved from this definition for years. Please, use the new definition, provided here: https://www.who.int/news-room/fact-sheets/detail/rehabilitation Response . Thank you very much for your comment. The new WHO definition of rehabilitation “a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions in interaction with their environment” has been added and the bibliographic reference has been updated. Reviewer: It is important to make the distinction between rehabilitation and disability - rehabilitation is a service for anyone - with or without a disability, and the other way around - many people with disabilities will require rehabilitation, but not all, and certainly they are not the only ones. Response . Thank you very much for your comment. A distinction has been made between rehabilitation and disability, emphasizing that not all individuals with disabilities require rehabilitation. Reviewer: ​​​​​​​In general, most of the references in the introduction are old. I would suggest to include more recent ones. There are a lot of systematic reviews published in the past 5 years. Response . Thank you very much for your comment. A new bibliographic search has been conducted, and the references have been updated accordingly. The majority of the cited articles are now less than five years old. Reviewer: ​​​​​​​WHO's new estimate of prevalence of disability is 16%, according to the Global report on health equity for persons with disabilities published in 2022. Response . Thank you very much for your comment; we agree. The global prevalence of disability has been updated to 16%, as reported in the 2022 Global Report on Health Equity for Persons with Disabilities. Reviewer: ​​​​​​​While it is true that WHO introduced the CBR approach, since 2017 WHO has been promoting the Rehabilitation 2030 initiative, which focuses on the overall importance of strengthening health systems to provide rehabilitation across all levels of care, including, but not only rehabilitation provided in the communities. I understand that you are providing examples before 2015 when your data is from, but I would certainly talk about Rehabilitation 2030, and simply give the CBR example of what was done in Chile, without emphasizing the whole CBR strategy as the only thing that WHO promotes, because it is not true. In addition, do you have any other evidence of what was done in Chile after 2015? Any new initiatives, is rehabilitation part of universal health coverage? Response . Thank you very much for your comment. We have revised the section discussing Community-Based Rehabilitation (CBR), placing greater emphasis on the Rehabilitation 2030 initiative and including examples of actions implemented in Chile after 2015. Reviewer: Methods In measurement of disability you say that the methodology is based on the MDS used by WHO in the II World Report on Disability, which is not true. It is based on the MDS and this is sufficient, because firstly, there is no II World Report on Disability, there is only one World Report on Disability, and second - MDS was created after the world report was published in 2011, so it cannot be included there. In addition, the MDS explores functioning, capacity (not health status), and environmental factors. Response . Thank you very much for your comment; we agree and regret the error. The information regarding the MDS has been corrected to indicate that it examines functioning, capacity, and environmental factors. Reviewer: Results I would also do an ad hoc or sensitivity analysis with the sample without disability and see whether there are any differences in the factors, compared to those with disabilities Response . Thank you very much for your comment; however, we respectfully disagree. This analysis focuses exclusively on the population with disabilities. Comparing the associated factors between individuals with and without disabilities falls outside the scope of the study's objectives. Reviewer: Discussion In the section "Prevalence of the use of rehabilitation services in people with disabilities" you are comparing your results with a systematic review on unmet needs for rehabilitation, which is not correct. Your analysis does not show gaps in the use of rehab services, because your questions does not ask that. Your question which you use as a dependent variable asks whether people with disabilities have used services, which indicates service utilization, not met or unmet needs. You don't know whether every person with a disability needs rehabilitation services? It may be that everyone who needed rehabilitation received it. The systematic review that you cite is based on questions like "did you receive rehabilitation when you needed it?" or something in this line. I would suggest you delete this section. Response . Thank you very much for your comment; we agree. We have decided to exclude this systematic review from the discussion. Reviewer: "this would be explained by the physical and intellectual demand that is necessary to achieve a higher level of education, and because of their condition, people with disabilities would not reach this level." - this is absolutely not true. There is no study that can show that having a disability makes it too effortful for someone to study. However, there are many studies showing that environmental barriers stop people with disabilities to study - lack of accessible educational materials, infrastructure in schools, negative attitudes by teachers, etc. Please, change this statement. Response . Thank you very much for your comment; we agree. This statement has been revised to emphasize environmental barriers as a primary factor contributing to the lack of access to education for individuals with disabilities. Reviewer: "The more significant disability in people with lower educational levels would explain our study’s greater need for rehabilitation services." - or maybe people with lower education don't have access to information and don't know that there are rehab services available. I am sure that if you run the same analysis with the sample of people without disability, you will find the same result. Response . Thank you very much for your comment. Both explanations have been included. Unfortunately, we do not have data on the use of rehabilitation services among individuals without disabilities. Therefore, we cannot conclude that lower educational attainment increases the use of rehabilitation services in this group. Reviewer: "According to our findings and the evidence reviewed, there is an increase in depressive symptoms in people who used rehabilitation services." - you used data from a cross-sectional study. How do you know that there is an increase in depressive symptoms due to the rehabilitation? You can't know that. You simply know that those who had rehabilitation also had depressive symptoms, but they may have had these symptoms already before, and maybe they don't have anything to do with the rehab process. Response . Thank you very much for your comment; we agree. The wording has been revised accordingly. Reviewer: "One of the consequences of disability is dependence on performing basic activities, which leads to the need for a caregiver" - this is not a consequence of a disability. It is simply that some people with disability, who have an underlying condition that require assistance may need a caregiver. Response . Thank you very much for your comment; we agree. The wording has been revised accordingly. Reviewer: In the paragraph on caregivers, it sounds like the persons with a disability does not have any opinion or decision, and everything depends on the caregiver, which is not true. I would soften the language and reflect the importance of persons with disabilities taking their own decisions, which, in some cases, can be taken by the caregivers in reality. Response . Thank you very much for your comment; we agree. We have ensured that the wording appropriately emphasizes the importance of individuals with disabilities making their own decisions. Reviewer: "First, social desirability and recall biases could alter the prevalence of rehabilitation services in persons with disabilities." - please, explain what you mean. Response . Thank you very much for your comment. The wording has been revised, and the explanation of social desirability and recall biases has been clarified and improved. Reviewer: please, change "chronic disabilities" with chronic health conditions. Response . Thank you very much for your comment. The term has been corrected. The discussion has not even one sentence on the implications of this study. What do these results mean? How can these results be used to address any gaps as you mention in the abstract? How are your findings important for research and clinical practice? Please, include some thoughts on that. Response . Thank you very much for your comment. A section is added to discuss the implications of the findings for public health in Chile. Reviewer: Conclusions "These results should guide rehabilitation professionals in identifying depressive or anxious conditions that may impair compliance and correct performance of therapies." - this doesn't make any sense. It is important, of course, that a rehab professional knows if a person has anxiety or depression, but I am not sure how will this change their intervention if someone has a physical disability? I would imagine that the person will also be treated for their depression or anxiety, but will this be done by the rehab professional? I think that more explanation is needed here. Response . Thank you very much for your comment. The conclusions have been revised to specify that health professionals, not exclusively rehabilitation professionals, should identify depressive or anxious conditions. View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Kamenov K. Peer Review Report For: Factors associated with the use of rehabilitation services among people with disabilities in Chile: A population-based study [version 2; peer review: 4 approved with reservations] . F1000Research 2025, 12 :73 ( https://doi.org/10.5256/f1000research.140812.r164255) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/12-73/v1#referee-response-164255 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions Adjust parameters to alter display View on desktop for interactive features Includes Interactive Elements View on desktop for interactive features Competing Interests Policy Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. Consider the following examples, but note that this is not an exhaustive list: Examples of 'Non-Financial Competing Interests' Within the past 4 years, you have held joint grants, published or collaborated with any of the authors of the selected paper. You have a close personal relationship (e.g. parent, spouse, sibling, or domestic partner) with any of the authors. You are a close professional associate of any of the authors (e.g. scientific mentor, recent student). You work at the same institute as any of the authors. You hope/expect to benefit (e.g. favour or employment) as a result of your submission. You are an Editor for the journal in which the article is published. Examples of 'Financial Competing Interests' You expect to receive, or in the past 4 years have received, any of the following from any commercial organisation that may gain financially from your submission: a salary, fees, funding, reimbursements. You expect to receive, or in the past 4 years have received, shared grant support or other funding with any of the authors. You hold, or are currently applying for, any patents or significant stocks/shares relating to the subject matter of the paper you are commenting on. Stay Updated Sign up for content alerts and receive a weekly or monthly email with all newly published articles Register with F1000Research Already registered? Sign in Not now, thanks close PLEASE NOTE If you are an AUTHOR of this article, please check that you signed in with the account associated with this article otherwise we cannot automatically identify your role as an author and your comment will be labelled as a “User Comment”. If you are a REVIEWER of this article, please check that you have signed in with the account associated with this article and then go to your account to submit your report, please do not post your review here. If you do not have access to your original account, please contact us . All commenters must hold a formal affiliation as per our Policies . The information that you give us will be displayed next to your comment. User comments must be in English, comprehensible and relevant to the article under discussion. We reserve the right to remove any comments that we consider to be inappropriate, offensive or otherwise in breach of the User Comment Terms and Conditions . Commenters must not use a comment for personal attacks. When criticisms of the article are based on unpublished data, the data should be made available. I accept the User Comment Terms and Conditions Please confirm that you accept the User Comment Terms and Conditions. Affiliation ✕ refresh Please enter your institution. Note: To add your institution or organisation, start typing the name and then select the correct name from the list. Where applicable, the name will appear in both the original language and in English. Do not paste in the name. If the name does not appear in the drop-down list, we will display the information you have entered. ✕ refresh Country/Region * USA UK Canada China France Germany Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Federated States of Micronesia Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and Mcdonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kosovo (Serbia and Montenegro) Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Minor Outlying Islands of the United States Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea North Macedonia Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Is South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand The Gambia The Netherlands Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu UK USA Uganda Ukraine United Arab Emirates United States Virgin Islands Uruguay Uzbekistan Vanuatu Venezuela Vietnam Wallis and Futuna West Bank and Gaza Strip Western Sahara Yemen Zambia Zimbabwe Please select your country/region. You must enter a comment. Competing Interests Please disclose any competing interests that might be construed to influence your judgment of the article's or peer review report's validity or importance. Competing Interests Policy Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. Consider the following examples, but note that this is not an exhaustive list: Examples of 'Non-Financial Competing Interests' Within the past 4 years, you have held joint grants, published or collaborated with any of the authors of the selected paper. You have a close personal relationship (e.g. parent, spouse, sibling, or domestic partner) with any of the authors. You are a close professional associate of any of the authors (e.g. scientific mentor, recent student). You work at the same institute as any of the authors. You hope/expect to benefit (e.g. favour or employment) as a result of your submission. You are an Editor for the journal in which the article is published. Examples of 'Financial Competing Interests' You expect to receive, or in the past 4 years have received, any of the following from any commercial organisation that may gain financially from your submission: a salary, fees, funding, reimbursements. You expect to receive, or in the past 4 years have received, shared grant support or other funding with any of the authors. You hold, or are currently applying for, any patents or significant stocks/shares relating to the subject matter of the paper you are commenting on. Please state your competing interests The comment has been saved. An error has occurred. Please try again. Cancel Post var lTitle = "Factors associated with the use of rehabilitation...".replace("'", ''); var linkedInUrl = "http://www.linkedin.com/shareArticle?url=https://f1000research.com/articles/12-73/v2" + "&title=" + encodeURIComponent(lTitle) + "&summary=" + encodeURIComponent('Read the article by '); var deliciousUrl = "https://del.icio.us/post?url=https://f1000research.com/articles/12-73/v2&title=" + encodeURIComponent(lTitle); var redditUrl = "http://reddit.com/submit?url=https://f1000research.com/articles/12-73/v2" + "&title=" + encodeURIComponent(lTitle); linkedInUrl += encodeURIComponent('Paredes-Laguna DS et al.'); var offsetTop = /chrome/i.test( navigator.userAgent ) ? 4 : -10; var addthis_config = { ui_offset_top: offsetTop, services_compact : "facebook,twitter,www.linkedin.com,www.mendeley.com,reddit.com", services_expanded : "facebook,twitter,www.linkedin.com,www.mendeley.com,reddit.com", services_custom : [ { name: "LinkedIn", url: linkedInUrl, icon:"/img/icon/at_linkedin.svg" }, { name: "Mendeley", url: "http://www.mendeley.com/import/?url=https://f1000research.com/articles/12-73/v2/mendeley", icon:"/img/icon/at_mendeley.svg" }, { name: "Reddit", url: redditUrl, icon:"/img/icon/at_reddit.svg" }, ] }; var addthis_share = { url: "https://f1000research.com/articles/12-73", templates : { twitter : "Factors associated with the use of rehabilitation services among.... Paredes-Laguna DS et al., published by " + "@F1000Research" + ", https://f1000research.com/articles/12-73/v2" } }; if (typeof(addthis) != "undefined"){ addthis.addEventListener('addthis.ready', checkCount); addthis.addEventListener('addthis.menu.share', checkCount); } $(".f1r-shares-twitter").attr("href", "https://twitter.com/intent/tweet?text=" + addthis_share.templates.twitter); $(".f1r-shares-facebook").attr("href", "https://www.facebook.com/sharer/sharer.php?u=" + addthis_share.url); $(".f1r-shares-linkedin").attr("href", addthis_config.services_custom[0].url); $(".f1r-shares-reddit").attr("href", addthis_config.services_custom[2].url); $(".f1r-shares-mendelay").attr("href", addthis_config.services_custom[1].url); function checkCount(){ setTimeout(function(){ $(".addthis_button_expanded").each(function(){ var count = $(this).text(); if (count !== "" && count != "0") $(this).removeClass("is-hidden"); else $(this).addClass("is-hidden"); }); }, 1000); } close How to cite this report {{reportCitation}} Cancel Copy Citation Details $(function(){R.ui.buttonDropdowns('.dropdown-for-downloads');}); $(function(){R.ui.toolbarDropdowns('.toolbar-dropdown-for-downloads');}); $.get("/articles/acj/128242/176509") new F1000.Clipboard(); new F1000.ThesaurusTermsDisplay("articles", "article", "176509"); $(document).ready(function() { $( "#frame1" ).on('load', function() { var mydiv = $(this).contents().find("div"); var h = mydiv.height(); console.log(h) }); var tooltipLivingFigure = jQuery(".interactive-living-figure-label .icon-more-info"), titleLivingFigure = tooltipLivingFigure.attr("title"); tooltipLivingFigure.simpletip({ fixed: true, position: ["-115", "30"], baseClass: 'small-tooltip', content:titleLivingFigure + " " }); tooltipLivingFigure.removeAttr("title"); $("body").on("click", ".cite-living-figure", function(e) { e.preventDefault(); var ref = $(this).attr("data-ref"); $(this).closest(".living-figure-list-container").find("#" + ref).fadeIn(200); }); $("body").on("click", ".close-cite-living-figure", function(e) { e.preventDefault(); $(this).closest(".popup-window-wrapper").fadeOut(200); }); $(document).on("mouseup", function(e) { var metricsContainer = $(".article-metrics-popover-wrapper"); if (!metricsContainer.is(e.target) && metricsContainer.has(e.target).length === 0) { $(".article-metrics-close-button").click(); } }); var articleId = $('#articleId').val(); if($("#main-article-count-box").attachArticleMetrics) { $("#main-article-count-box").attachArticleMetrics(articleId, { articleMetricsView: true }); } }); var figshareWidget = $(".new_figshare_widget"); if (figshareWidget.length > 0) { window.figshare.load("f1000", function(Widget) { // Select a tag/tags defined in your page. In this tag we will place the widget. _.map(figshareWidget, function(el){ var widget = new Widget({ articleId: $(el).attr("figshare_articleId") //height:300 // this is the height of the viewer part. [Default: 550] }); widget.initialize(); // initialize the widget widget.mount(el); // mount it in a tag that's on your page // this will save the widget on the global scope for later use from // your JS scripts. This line is optional. //window.widget = widget; }); }); } close Error Close Add Reset F1000.MICROSERVICES.AFFILIATION = ''; $(document).ready(function () { $('.js-affiliations-form').each((index, form) => { new AffiliationForm({ formId: form.id, institutionErrorSelector: '.comment-enter-institution', departmentErrorSelector: '.comment-enter-department', placeSelector: '.js-add-comment-place', stateSelector: '.js-add-comment-state', zipCodeSelector: '.js-add-comment-zipcode', countrySelector: '.js-add-comment-country', countryErrorSelector: '.comment-enter-country', }); }); }); $(document).ready(function () { var reportIds = { "170496": 0, "369165": 0, "369164": 0, "369167": 0, "369166": 0, "369163": 2, "369172": 0, "369169": 0, "369168": 0, "369171": 0, "369170": 0, "170524": 0, "177954": 0, "177955": 0, "177952": 0, "177959": 8, "177956": 0, "177957": 0, "177962": 0, "177963": 0, "177960": 0, "177961": 0, "177965": 0, "376637": 0, "376636": 0, "362559": 0, "376639": 0, "362558": 5, "376638": 0, "376633": 0, "376632": 0, "376635": 0, "376634": 0, "362565": 0, "362564": 0, "362567": 0, "362566": 0, "362561": 0, "376641": 0, "362560": 0, "376640": 0, "362563": 0, "362562": 0, "365421": 0, "365420": 0, "170856": 0, "365423": 0, "365422": 0, "365419": 0, "365418": 0, "365425": 0, "365424": 0, "365427": 0, "365426": 0, "370325": 0, "370324": 0, "370327": 0, "370326": 0, "370323": 0, "370332": 0, "370329": 0, "164255": 18, "370328": 0, "370331": 0, "370330": 0, "169642": 0, "363957": 0, "363956": 0, "363959": 0, "363958": 0, "363955": 0, "363964": 0, "363961": 0, "363960": 0, "363963": 0, "363962": 0, "368077": 0, "360909": 0, "368076": 0, "360908": 0, "368079": 0, "360911": 0, "368078": 0, "360910": 0, "368073": 0, "368072": 0, "368075": 0, "360907": 0, "368074": 0, "360916": 0, "368081": 0, "360913": 0, "368080": 0, "360912": 0, "360915": 0, "360914": 0, "160735": 0, "160738": 0, "379109": 0, "160739": 0, "379108": 0, "160736": 0, "366823": 0, "379111": 0, "160737": 0, "366822": 0, "379110": 0, "360161": 0, "160740": 0, "379107": 0, "360162": 0, "379106": 0, "366829": 0, "366828": 0, "366831": 0, "366830": 0, "366825": 0, "379113": 0, "366824": 0, "379112": 0, "366827": 0, "379115": 0, "366826": 0, "379114": 0, }; $(".referee-response-container,.js-referee-report").each(function(index, el) { var reportId = $(el).attr("data-reportid"), reportCount = reportIds[reportId] || 0; $(el).find(".comments-count-container,.js-referee-report-views").html(reportCount); }); var uuidInput = $("#article_uuid"), oldUUId = uuidInput.val(), newUUId = "c0feafe1-2b8c-46d0-92d3-1c32fd6f85d3"; uuidInput.val(newUUId); $("a[href*='article_uuid=']").each(function(index, el) { var newHref = $(el).attr("href").replace(oldUUId, newUUId); $(el).attr("href", newHref); }); }); An innovative open access publishing platform offering rapid publication and open peer review, whilst supporting data deposition and sharing. Browse Gateways Collections How it Works Contact For Developers Cookie Notice Privacy Notice RSS Submit Your Research Follow us © 2012-2026 F1000 Research Ltd. ISSN 2046-1402 | Legal | Partner of Research4Life • CrossRef • ORCID • FAIRSharing R.templateTests.simpleTemplate = R.template(' $text $text $text $text $text '); R.templateTests.runTests(); var F1000platform = new F1000.Platform({ name: "f1000research", displayName: "F1000Research", hostName: "f1000research.com", id: "1", editorialEmail: "[email protected]", infoEmail: "[email protected]", usePmcStats: true }); $(function(){R.ui.dropdowns('.dropdown-for-authors, .dropdown-for-about, .dropdown-for-myresearch');}); // $(function(){R.ui.dropdowns('.dropdown-for-referees');}); $(document).ready(function () { if ($(".cookie-warning").is(":visible")) { $(".sticky").css("margin-bottom", "35px"); $(".devices").addClass("devices-and-cookie-warning"); } $(".cookie-warning .close-button").click(function (e) { $(".devices").removeClass("devices-and-cookie-warning"); $(".sticky").css("margin-bottom", "0"); }); $("#tweeter-feed .tweet-message").each(function (i, message) { var self = $(message); self.html(linkify(self.html())); }); $(".partner").on("mouseenter mouseleave", function() { $(this).find(".gray-scale, .colour").toggleClass("is-hidden"); }); }); Sign In Remember me Forgotten your password? Sign In Cancel Email or password not correct. Please try again Please wait... $(function(){ // Note: All the setup needs to run against a name attribute and *not* the id due the clonish // nature of facebox... $("a[id=googleSignInButton]").click(function(event){ event.preventDefault(); $("input[id=oAuthSystem]").val("GOOGLE"); $("form[id=oAuthForm]").submit(); }); $("a[id=facebookSignInButton]").click(function(event){ event.preventDefault(); $("input[id=oAuthSystem]").val("FACEBOOK"); $("form[id=oAuthForm]").submit(); }); $("a[id=orcidSignInButton]").click(function(event){ event.preventDefault(); $("input[id=oAuthSystem]").val("ORCID"); $("form[id=oAuthForm]").submit(); }); }); If you've forgotten your password, please enter your email address below and we'll send you instructions on how to reset your password. The email address should be the one you originally registered with F1000. Email address not valid, please try again You registered with F1000 via Google, so we cannot reset your password. To sign in, please click here . If you still need help with your Google account password, please click here . You registered with F1000 via Facebook, so we cannot reset your password. To sign in, please click here . If you still need help with your Facebook account password, please click here . Code not correct, please try again Reset password Cancel Email us for further assistance. Server error, please try again. If your email address is registered with us, we will email you instructions to reset your password. If you think you should have received this email but it has not arrived, please check your spam filters and/or contact for further assistance. Please wait... Register $(document).ready(function () { signIn.createSignInAsRow($("#sign-in-form-gfb-popup")); $(".target-field").each(function () { var uris = $(this).val().split("/"); if (uris.pop() === "login") { $(this).val(uris.toString().replace(",","/")); } }); });