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Introduction[edit | edit source]
There is a growth need for health care rehabilitation systemas there is an increase worldwide population, near future we will need eehabilitation system to cope with the increasement. According to WHO there is more than 50% of people who need rehabilitation in low and middle income counteres don’t receive rehabilitation. Nowdays , globally there is 1in 3 people need to receive rehabilitation according to WHO.
Rehabilitation is a process to restore the useful and heathy life of the persone to be independent as he can try to restore his /her life before the injury, or illness. It is defined as an Algorithm-based progressions process. WHO definition to rehabilitation" “a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions in interaction with their environment”.
Level of rehabilitation and care depend on the acuity , complexity of the patient.vary to cover person’s all stages till full recovery or be able to co operate with the society, they range from acute care in acute illness/ injury that need rapid intervention, going through the patient’s stable phase in which the medical condition is stable enough to transmit to the next step of care sub acute care then to long term care rehabilitation that carried at rehabilitation centers, or at home. Before we start we need to know the level of rehabilitation and care depend on the acuity , complexity of the patient’s condition. Recording Measurements during rehabilitation process provide a visual and document evidence for patient and the doctor about improvement.
Acute Care[edit | edit source]
Definition:[edit | edit source]
There isn’t definite term for acute care, it is defined as a service provided to individuals/ population, it is time dependant and deal with urgent, un expected, sudden injury or acute episodes of illness that it may be life threating condition or may lead to disability, and need rapid intervention. Patient in this stage is usually under unstable medical condition, deal with variety of care delivery platforms as follows 1:
Acute Surgery:[edit | edit source]
Acute surgical needs include intra- abdominal crises in general: eg, appenditis, intestinal obstruction, is the most common cause of hospital admission.
Emergency Care[edit | edit source]
Is carried by general practitioners GPs, to prevent irreversible complications. Carried at hospital ‘s emergency department, they assess the airway, breathing, circulatory, and treat critically ill people to stabilize their condition Depending on the degree of the severity, some cases can be managed at the emergency department while others will be referred to a specialist with appropriate referral and transport facilities. For example: sever wounds injury may cause internal bleeding, stroke, heart attack, cerebrovascular accidents.
Urgent Care[edit | edit source]
Carried outside the emergency department of hospital and don’t follow schedule, treat conditions that need immediate care but not serious or urgent need attention within 24 h but not life threating. Such as minor injury (sprain, strain, bone break), seasonal illness child fever for example, or follow of chronic illness eg blood pressure, or UTI.
Short Term Stabilisation[edit | edit source]
From name stabilize the patient, directed toward decrease and control the symptoms until receive the definite treatment. 5-Prehospital care: care carried and provided before the patient arrive the hospital, for example delivery of persone with trauma. divided according to WHO into three steps:
- First Responder Care
- Basic Prehospital Care
- Advanced Prehospital Care
Critical Care, for the patient who need ICU, usually with respiratory problems.
Services Provided at acute care[edit | edit source]
They need a multidisciplinary approach to ensure the patient will return to functional daily life. Therapy usually lasts three hours or more per day. They receive therapy at least 5 days/ week, and daily assessment face-to-face and therapy plan update continuously. Patients will receive a combination of rehabilitative care (physical, occupational, respiratory, and speech therapy as needed) according to the patient’s condition and pre-requisites for each case. Acute care help patients to improve their quality of life and help them to improve till transmit to sub acute care or next step of care whatever it is. Selection of inpatient to transfer from acute care to next rehabilitation phase an important decision impact on quality care provided to him and, patient’s life.
Sub-acute Care[edit | edit source]
Care provided for patients without severity illness, stable conditions, and received their definitive acute care as it was required. We can say, it is a care (for whom no longer meet the criteria of acute care but still need care at hospital) with more intense care than usually. There are many definition for sub-acute care according to associations and literatures as listed here.
Where it Occurs[edit | edit source]
It is carried at hospital, home, health care centers, or specialist rehabilitation centers.
Benefits Sub-acute Care[edit | edit source]
Decrease the time of hospitalization if it is carried in hospital. Help to act independently as soon as possible. Help to understand next steps, bring the patient to the highest level of function as possible as before. Help to return to normal live pre injury/ illness, help to manage the changes that happened and to manage your everyday tasks
Services Provided at Sub-acute Care[edit | edit source]
Therapy lasts for 2 hours or less/ day. Patients’ family members are involved in the meeting with their care team to ensure everyone is working toward the same goals. The focus is on regaining strength, mobility, and long-term functionality over the course of therapy A combination of physical, occupational and speech therapy are used for best results if the patient need. Examples here
Criteria Sub-acute Care[edit | edit source]
The InterQual Level of Care Criteria: contain criteria about patient admission, hospitalization time, and discharge review criteria that matches with patient states at every phase of care acute, sub-acute, and discharge to home. According to IQC, to determine the patient at acute care availability to sub acute care, should meet the criteria of pre-admission eligibility that tested via pre-admission review. The patient must fulfill criteria from one of the following (having an illness, injury, or surgery, impairments that require assistance, meeting clinical stability, patient having an ability to endure a rehabilitation program, finally can’t be able to be managed in a lower level of care than he/she tested in. The patient should be medically stable to can include him/her in the rehabilitation programme and can cooperate, in other conditions some patients are in acute care, medical stable and can take part in.
Long Term Care[edit | edit source]
Long Term Care (LTC) iscare provided for either a short or long period of time, to people with chronic illness or disability, who don’t need specialized medical care, they may be an adult or elder person, in order to improve their quality of life, and helping them to meet their needs over time.
Include assisting with medical needs and daily living activities eg, dressing, moving from bed to chair, bathroming, etc. LTC need un specialized , unskilled care and can be provided at home, nursing homes, LTC facilities. Focus on services and interventions to increase person’s independency.
Care communities provide a broad range of health care, personal care, and supportive services for adults who have limited self-care capabilities. In USA about 2.1 million reside in long-term care facilities1.
Types[edit | edit source]
Informal/ unpaid care, often provided by one’s relatives and friends. Now days, there is a decline in the informal care specially in the modern societies, where tendency to form small families and to be independence.
According to WHO. Majority of informal LTC provided by spouses and adult children specially daughter, two third of primay care givers are women 2.
Formal/ paid care, provided by health care institution, nusrsing, eg; LTC facilities
Resources[edit | edit source]
References [edit | edit source]