Daytime hospital. The total amount of necessary funds for course treatment without hospitalization

In addition to outpatient and inpatient care, medical care is widely used in the so-called day hospitals. This is a kind of intermediate variant between the outpatient regime of the polyclinic and the inpatient treatment.

In each area of medicine there is a list of indications, which are the basis for sending the patient to a day hospital. Patients' feedback, like statistics, testifies to the convenience and effectiveness of this form of medical care.

What is a day hospital?

The day hospital is one of the structural divisions of the treatment and prophylactic institution, intended for patients who do not need round-the-clock monitoring of their condition and supervision of medical personnel.

Being a full-fledged branch of the medical and preventive institution, the day hospital in full has access to all the facilities available at its disposal for medical, diagnostic, consultative, and rehabilitation units.

The most common day hospitals, with the following profile:

• Therapeutic.
• Surgical.
• Obstetric and gynecological.
• Neurological.
• Dermatological.

Organization

The number of beds in the day hospital (the so-called indicator of hospital capacity) is determined by the head of the treatment and prophylactic institution, based on the total hospital capacity of the institution, the real needs of the population for medical care and the estimated daily hospital load. The number of beds is coordinated with the authorized health authority.

Established posts of medical personnel are determined by the head physician of the institution, based on the bed capacity, medical profile and mode of functioning. If there are no specialists in the day hospital, the patients are provided with the consultative help of the doctors of the relevant specialties who are in the staff of the medical institution and who work in the relevant profile departments.

If the day-care center is part of a 24-hour in-patient facility, then its patients must be provided with a two-time meal in accordance with the current regime adopted in this treatment-and-prophylactic institution.

Medicamentous support of the day hospital is carried out in full or in part at the expense of the medical and prophylactic institution, on the basis of which the day hospital is functioning.

Day hospitals, established on the basis of hospital facilities, differ from similar units of the outpatient clinic with the ability to conduct a wider range of diagnostic procedures, as well as more opportunities in organizing rehabilitation activities. On the basis of this department, it is possible to perform more complex, in comparison with the clinic institution, diagnostic and therapeutic manipulations.

Directions of day hospital work

The 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 patient's observation specialist).
• Treatment of patients requiring observation at the time of therapeutic procedures, but not requiring round-the-clock monitoring of the condition.
• Rehabilitation measures in the amounts available to the rehabilitation services of this treatment and prevention institution.

The amount of medical care provided in the day hospital

1. Intramuscular, subcutaneous and intravenous injections.
2. Intravenous infusions of medicinal solutions.
3. Observation and treatment of patients who completed inpatient treatment and were discharged at an early age from the hospital and received recommendations on the completion of therapy and rehabilitation in an active regime.
4. Medical observation of patients who underwent uncomplicated surgical interventions under stationary conditions, after which they do not need round-the-clock medical supervision (postoperative period after such interventions as, for example, surgical treatment of benign neoplasms, interference with ingrown nails, uncomplicated phlegmon, Panarization).

Indications for treatment in a day hospital

• 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.
• Conducting diagnostic procedures that do not imply a 24-hour monitoring of the patient's condition.
• Treatment of diseases with 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 a 24-hour hospital stay.

• Impossibility to hospitalize a patient in a 24-hour hospital for reasons that depend on the patient.
• Patients on outpatient treatment who require medical supervision during the treatment procedure (vasoactive drugs, hyposensitizing and desensitizing therapy, intraarticular injections).
• The need for intravenous drip administration of drugs: in this case, a dynamic observation is necessary. For example, cardiac glycosides, glucocorticosteroids, antiarrhythmic drugs.
• The need to monitor the patient during minor interventions or diagnostic procedures (eg, endoscopy).
• Necessity of carrying out diagnostic measures that require long-term preparation (intravenous pyelography, bronchoscopy, biopsy of the gastrointestinal mucosa).
• The emergence of the patient during his stay in the clinic emergency conditions (such as hypertensive crisis, collapse, attack of angina); - before the stabilization of the condition and the arrival of an ambulance.

Contraindications to referral to day hospital

• The need to monitor the patient's condition around the clock on the background of ongoing treatment. The work of the day hospital is carried out in the daytime, so these patients must be hospitalized in a 24-hour hospital.
• A patient's condition requiring bed rest.
• Limited patient's ability to move.
• Patients suffering from diseases characterized by aggravation or deterioration at night can not pass.
• Severe concomitant pathology, which can provoke complication of the underlying disease.

Disability

Treatment in a day hospital does not imply permanent residence in a medical institution, but this implies that the patient has a serious illness, as well as the need to be treated for a long time. Therefore, it is advisable for the patient to issue a certificate of incapacity for the duration of stay in the day hospital. A patient will spend several hours a day in a medical institution, so he will not be able to stay in 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 of medical service and sphere of education should be carried out; Long-term students who are on treatment should be able to master the curriculum on a par with peers.
• Possibility of the child's stay together with one of the parents (relevant for cases when an early child is sent to a children's day hospital).

Day hospital during pregnancy

The condition of the expectant mother requires a lot of attention on the part of medical workers. Due to the peculiarities of the course of diseases during pregnancy, many of them are included in the list of indications for the stay of a pregnant woman in a day hospital:

• Stable and pronounced arterial hypotension.
• Arterial hypertension, manifested in any of the trimesters of pregnancy.
• Anemia.
• Early toxicosis.
• A day hospital during pregnancy is indicated if there is a 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 the anamnesis.
• The need for invasive diagnostic manipulations (such as chorionic biopsy or amniocentesis).
• Examination associated with Rh-conflict in pregnant women.
• In the case of ischemic-cervical insufficiency: dynamic observation after suturing the cervix.
• Recovery period after prolonged inpatient treatment, in case the patient continues to need long-term medical supervision.

Any emergency conditions that arise during pregnancy should be analyzed in terms of child safety. In case of danger to the fetus, the woman should be hospitalized in a 24-hour hospital.