Along with outpatient and inpatient treatments, the provision of medical care in the conditions of so-called day hospitals is widespread. This is a kind of intermediate option between the outpatient regime of the clinic and inpatient treatment.
In each field of medicine there is a list of indications that are the basis for referring the patient to an inpatient department. Patient reviews, as well as statistics, indicate the convenience and effectiveness of this form of medical care.
What is a day hospital
Day hospital is one of the structural units of the medical institution, designed for patients who do not need round-the-clock monitoring of their condition and the supervision of medical personnel.
Being a full-fledged department of a medical institution, the full-time hospital has full access to all the possibilities of the medical, diagnostic, consultative, and rehabilitation units at its disposal.
The most common day hospitals with the following profile:
- Therapeutic.
- Surgical.
- Obstetric and gynecological.
- 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 real need of the population for medical care and the estimated load of the day hospital. The number of beds is agreed with the authorized health authority.
The staffing positions of medical personnel are determined by the head physician of the institution, based on bed capacity, medical profile and mode of functioning. In the absence of specialized specialists in the staff of the day hospital, patients are provided with the advisory help of doctors of the corresponding specialties, who are in the staff of the medical institution and work in the relevant specialized departments.
If the day care hospital is part of a round-the-clock hospital, then its patients should be provided with two meals a day in accordance with the current regime adopted in this medical institution.
Drug support for 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 is functioning.
Day hospitals, created on the basis of hospitals, differ from similar units of the outpatient service in the possibility of a wider range of diagnostic procedures, as well as more opportunities in organizing rehabilitation measures. On the basis of such a department, it is possible to carry out more complex, in comparison with a polyclinic institution, diagnostic and therapeutic manipulations.
Directions of the day hospital
A day hospital provides medical assistance to the population in the following areas:
- Preventive measures, in particular, prevention of exacerbations of long-term chronic diseases (in accordance with the recommendations of the observing patient of a specialized specialist).
- Treatment of patients requiring observation during the duration of therapeutic procedures, but not in need of round-the-clock monitoring of the condition.
- Rehabilitation measures in the volumes available to the rehabilitation services of this medical institution.
The amount of medical care provided in the day hospital
- Intramuscular, subcutaneous and intravenous injections.
- Intravenous infusion of drug solutions.
- Observation and treatment of patients who completed inpatient treatment and were discharged early from the hospital and received recommendations on completion of therapy and rehabilitation in an active mode.
- Medical monitoring of patients who underwent simple surgical interventions in an inpatient setting, 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, surgery for ingrown toenails, uncomplicated phlegmon, panaritium).
Indications for treatment in a day hospital
- The implementation of therapeutic procedures recommended to the patient when he completed inpatient treatment, and not requiring constant, round-the-clock monitoring of the patient's condition.
- Carrying out diagnostic procedures that do not imply round-the-clock monitoring of the patient's condition.
- Treatment of diseases having an acute or chronic course that does not require round-the-clock monitoring.
Implementation of a set of measures for the rehabilitation of the patient in those cases when he does not need to be around the clock in a hospital.
- Inability to hospitalize a patient in a round-the-clock hospital for patient-specific reasons.
- Patients undergoing outpatient treatment requiring medical supervision during the treatment procedure (vasoactive drugs, hyposensitizing and desensitizing therapy, intraarticular injections).
- The need for intravenous drip of drugs: in this case, dynamic observation is necessary. For example, cardiac glycosides, glucocorticosteroids, antiarrhythmic drugs.
- The need to monitor the patient during minor interventions or diagnostic procedures (e.g., endoscopy).
- The need for diagnostic measures that require extensive preparation (intravenous pyelography, bronchoscopy, biopsy of the mucous membrane of the gastrointestinal tract).
- The emergence of a patient during a stay in the clinic emergency conditions (such as hypertensive crisis, collapse, angina attack); - until the condition stabilizes and the ambulance arrives.
Contraindications to referral to day hospital
- The need to monitor the patient’s condition around the clock against the background of the treatment. The work of the day hospital is carried out in the daytime, therefore, such patients should be hospitalized in a round-the-clock type hospital.
- Patient's condition requiring bed rest.
- Patient's limited mobility.
- Patients suffering from diseases whose characteristic feature is an exacerbation or worsening of the condition at night cannot pass.
- Severe concomitant pathology that can provoke a complication of the underlying disease.
Disability
Treatment in a day hospital does not imply a permanent stay in a medical institution, but this implies the presence of a serious illness in the patient, as well as the need for a long time to be treated. Therefore, it is advisable for the patient to issue a disability certificate for the duration of the stay in the day hospital. A patient will spend several hours a day at the hospital, so he will not be able to stay at the workplace for most of the working day.
Pediatric Day Hospital
Children's day hospital has a number of features:
- Based on them, close cooperation of the medical service and the education sector should be carried out; students who are on treatment for a long time should be able to master the curriculum along with peers.
- The possibility of a child staying with one of the parents (relevant for cases when a young child is sent to the children's day hospital).
Day hospital during pregnancy
The condition of the future mother requires a lot of attention from the medical staff. In connection with 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:
- Persistent and severe arterial hypotension.
- Arterial hypertension, manifested in any of the trimesters of pregnancy.
- Anemia.
- Early toxicosis.
- A 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 preservation of the cervix and the absence of miscarriages in history.
- The need for invasive diagnostic procedures (such as a chorionic biopsy or amniocentesis).
- Examination related to the Rh conflict in a pregnant woman.
- In case of isthmic-cervical insufficiency: dynamic observation after suturing the cervix.
- The recovery period after prolonged inpatient treatment, if the patient continues to need long-term medical supervision.
Any emergency conditions that occur during pregnancy should be analyzed in terms of the safety of the baby. In case of danger to the fetus, the woman should be hospitalized in a round-the-clock hospital.