PubMed · 6909786
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N Mounsey. 1981-05-07. Creative day care.. https://pubmed.ncbi.nlm.nih.gov/6909786/
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Partial-hospitalization rehabilitation is a relatively recent form of rehabilitation, which, as opposed to the ambulatory approach, comprises the entire programme available for inpatient medical rehabilitation except for accommodation and full board. Great expectations are attached to partial hospitalization: it is supposed to cost less than a comparable in-patient measure but matching in terms of quality. However, hardly any empirical data exist so far concerning the effects partial hospitalization rehabilitation is having in these respects. The present article seeks to answer the question of whether from a patient perspective, the outcome quality of this new model is comparable to that of the classical full-hospitalization programmes. In terms of methodology, questionnaires were used to raise the necessary data from two independent samples (i.e., partial vs. full hospitalization) of former orthopaedic rehabilitees of Fachklinik Ichenhausen (Bavaria). Data analysis included some 205 patient questionnaires (57% return rate). High agreement was found among the two groups concerning outcome evaluation, subjective health and patient satisfaction. From a patient perspective, rehabilitation outcome on the majority of variables considered, even is judged slightly better for partial hospitalization patients than for the inpatient comparison group. As none of these results reach statistical significance, these minor differences should however not be overrated. While partial-hospitalization, rehabilitation, hence, has turned out an option which matches traditional full-hospitalization programmes in terms of quality, too great expectations nevertheless are unwarranted: Partial-hospitalization rehabilitation is no general alternative to inpatient programmes as it will realistically be suitable for a small percentage of orthopaedic patients only, hence be unable to replace full-hospitalization programmes to any major extent. Undoubtedly, however, it is apt to contribute to greater flexibility and needs orientation among the services and programmes available in rehabilitation, and may thus be considered a valuable approach for complementing inpatient and ambulatory forms of rehabilitation.
Day clinic rehabilitation is part of the development of the medical rehabilitation system. Psychosomatic rehabilitation faces the task of developing a concept of day treatment and of collecting experiences with such models in clinical practice. The basis of this task consists in regulations laid down by the social security insurance authorities which serve as a frame for the development. The main points of these regulations are presented and their relevance for psychosomatic rehabilitation is outlined. The institutional and conceptual establishment of day treatment presents psychosomatic rehabilitation with a number of problems that are particular in this area and which are discussed in detail. Besides that, consequent elaboration of day treatment could stimulate further development of psychosomatic rehabilitation in general and help to overcome prevailing shortcomings of this part of the rehabilitation system.
There has recently been a move towards generic palliative care with the extension of the aims, as specified by the WHO (1) to patients with non-malignant diagnoses. Trinity Hospice, London, UK, changed their admissions policy to include any patient with a specialist palliative care need from January 1 1995. The contents of this brief report were first presented as a poster at the EAPC Conference, Barcelona, December 1995.