Along with the outpatient and inpatient types of treatment, the provision of medical care in the so-called day hospitals is widespread. This is a kind of intermediate option between the outpatient clinic and inpatient treatment.
In each area of medicine there is a list of indications that are the basis for referring a patient to a day hospital. Patient reviews, as well as statistics, testify to the convenience and effectiveness of this form of medical care.
What is a day hospital
A day hospital is one of the structural subdivisions of a medical institution designed for the stay of patients who do not need round-the-clock monitoring of their condition and supervision of medical personnel.
Being a full-fledged department of a medical institution, a day hospital has full access to all the possibilities of medical, diagnostic, consultative, andrehabilitation units.
The most common day hospitals have the following profile:
- Therapeutic.
- Surgical.
- Obstetrics and gynecology.
- Neurological.
- Dermatological.
Organization
The number of beds in a day hospital (the so-called bed capacity indicator) is determined by the head of the medical institution, based on the total bed capacity of the institution, the actual need of the population for medical care and the estimated load of the day hospital. The number of beds is agreed with the authorized he alth authority.
Regular positions of medical personnel are determined by the head physician of the institution, based on the bed capacity, medical profile and mode of operation. In the absence of narrow specialists in the staff of the day hospital, patients are provided with consultative assistance from doctors of relevant speci alties, who are on the staff of the medical institution and work in the relevant specialized departments.
If a day hospital is part of a 24-hour hospital, then its patients should be provided with two meals a day in accordance with the current regime adopted in this medical institution.
Medical support of the day hospital is carried out in whole or in part at the expense of the medical institution, on the basis of which the day hospital operates.
Day hospitals created on the basis of hospitals differ from similar units of the outpatient service in the possibility of carrying out a wider range of diagnostic procedures, as well as more opportunities in organizing rehabilitation activities. On the basis of such a department, it is possible to carry out more complex diagnostic and therapeutic procedures compared to a polyclinic institution.
Directions of the Day Hospital
The day hospital provides medical care to the population in the following areas:
- Preventive measures, in particular, the prevention of exacerbations of long-term chronic diseases (in accordance with the recommendations of the specialist observing the patient).
- Treatment of patients who require observation during therapeutic procedures, but do not need round-the-clock monitoring.
- Rehabilitation activities in the volumes available to the rehabilitation services of this medical institution.
Volume of medical care provided in the day hospital
- Intramuscular, subcutaneous and intravenous injections.
- Intravenous infusion of drug solutions.
- Follow-up and treatment of patients who completed inpatient treatment and were discharged early from the hospital and received recommendations to complete therapy and rehabilitation under active regimen.
- Medical supervision ofpatients who have undergone simple surgical interventions in a hospital, after which they do not need round-the-clock medical supervision (we are talking about the postoperative period after such interventions as, for example, surgical treatment of benign neoplasms, intervention for an ingrown nail, uncomplicated phlegmon, panaritium).
Indications for day hospital treatment
- The implementation of therapeutic procedures recommended to the patient when he completed inpatient treatment, and does not require constant, round-the-clock monitoring of the patient's condition.
- Performing diagnostic procedures that do not imply round-the-clock monitoring of the patient's condition.
- Treatment of diseases that have an acute or chronic course that does not require round-the-clock supervision.
Implementation of a set of measures for the rehabilitation of the patient in cases where he does not require a round-the-clock stay in a hospital.
- Inability to hospitalize a patient in a round-the-clock hospital for reasons dependent on the patient.
- Outpatients requiring medical supervision during treatment (vasoactive drugs, hyposensitizing and desensitizing therapy, intra-articular injections).
- The need for intravenous drip of drugs: in this case, dynamic monitoring is necessary. For example, cardiac glycosides, glucocorticosteroids, antiarrhythmic drugs.
- The need to monitor the patient during minor interventions or diagnostic procedures (such as endoscopy).
- The need for diagnostic measures that require lengthy preparation (intravenous pyelography, bronchoscopy, biopsy of the mucous membrane of the gastrointestinal tract).
- Occurrence in a patient during a stay in the clinic of emergency conditions (such as hypertensive crisis, collapse, angina attack); - until the condition stabilizes and the ambulance arrives.
Contraindications for referral to a day hospital
- The need to monitor the patient's condition around the clock against the backdrop of ongoing treatment. The work of the day hospital is carried out during the daytime, so such patients should be hospitalized in a 24-hour hospital.
- Patient condition requiring bed rest.
- Restricted patient mobility.
- Patients suffering from diseases characterized by aggravation or worsening at night cannot pass.
- Severe concomitant pathology that can provoke a complication of the underlying disease.
Disability
Day hospital treatment does not mean a permanent stay in a medical institution, but it does mean that the patient has a serious illness, as well as the need for a long time in treatment. Therefore, it is advisable for the patient to issue a certificate of incapacity for work during the stay in a day hospital. The patient will spend several hours per day in a medical institution, so he will not be able to be at the workplace for most of the working day.
Day hospital in pediatrics
Children's Day Hospital has a number of features:
- On their basis, close cooperation between the medical service and the education sector should be carried out; long-term care students should be able to learn the curriculum on a par with their peers.
- The possibility of a child staying together with one of the parents (relevant for cases when a child of an early age is sent to a children's day hospital).
Day hospital during pregnancy
The condition of the future mother requires a lot of attention from medical workers. Due to the peculiarities of the course of diseases during pregnancy, many of them are included in the list of indications for a pregnant woman to stay in a day hospital:
- Sustained and severe arterial hypotension.
- Hypertension, manifested in any of the trimesters of pregnancy.
- Anemia.
- Early toxicosis.
- Day hospital during pregnancy is indicated for the threat of premature termination of pregnancy in the first or second trimesters. An important condition is the safety of the cervix and the absence of miscarriages in history.
- The need for invasive diagnosticprocedures (such as chorion biopsy or amniocentesis).
- Examination related to Rh incompatibility in a pregnant woman.
- In case of isthmic-cervical insufficiency: dynamic observation after suturing the cervix.
- Recovery period after long-term inpatient treatment, if the patient continues to need long-term medical supervision.
Any medical emergency that occurs during pregnancy should be reviewed for the safety of the baby. In case of danger to the fetus, the woman should be hospitalized in a 24-hour hospital.
