About the advantages of day hospitals. How long are they in hospital?


Over the past two and a half years, a lot of attention has been paid to hospital-replacement technologies. Currently, all outpatient centers in the Southern District operate day hospitals that can accommodate patients who do not require round-the-clock care.

Questions arise - under what conditions can you get into a day hospital for treatment, for what diseases, and what is their advantage over all the usual inpatient facilities in our hospitals. The head of the Southern District Health Directorate, Andrei Belostotsky, spoke about all this.

Andrey Viktorovich, tell us what day hospitals are and what purposes do they serve?
- Day hospitals are essentially no different from regular inpatient facilities in hospitals. The only difference is that if the patient does not require round-the-clock medical care and observation, he can go to a day hospital and receive everything necessary treatment during the day, and in the evening return home to your family. This is very convenient especially for those who cannot afford to disconnect from their busy work schedule to conduct full treatment in a hospital inpatient unit. And in this case, the real way out is a day hospital. The patient came to the clinic in the morning, received treatment, and received necessary research, put on an IV, etc., and after a couple of hours or in the evening the patient is already free and can go home.

Day hospital specialists select adequate therapy for patients with a newly diagnosed disease or for chronic patients with an exacerbation of the process or a change in the severity of the disease. They also provide comprehensive course treatment using modern medical technologies, rehabilitation of sick and disabled people, pregnant women. Day hospital beds are deployed both at hospitals and in every outpatient center in the Southern District, and in some branches of these centers.

- How to get treatment at a day hospital?
- A referral for a course of treatment in a day hospital is issued by the attending physician, again, if the patient does not require round-the-clock supervision. You can also get a referral from the prevention department, other specialized institutions such as dispensaries, and from hospitals.

In addition, the following situation can be cited as an example: a person, say, has a hypertensive crisis. He called " ambulance", which provided medical assistance and carried out all the necessary procedures on site. Further, in order to reduce the risks of a repeat crisis, emergency doctors send the patient’s testimony to the clinic where he is being served, and if prolonged treatment is necessary, the attending physician at the clinic refers the patient to a day hospital.

- Medical and medicinal assistance Is it paid or free in day hospitals?
- Medical and drug assistance to the population in a day hospital is provided within the framework of the territorial Program of State Guarantees for Providing Citizens Russian Federation free medical care, as well as on the terms of voluntary medical insurance or paid medical services in accordance with the current legislation of the Russian Federation.

- What diseases are treated in the day hospital?
- The district operates day hospitals for several disease profiles. In addition to therapeutic beds, there are also gynecological, neurological, surgical, tuberculosis and many others. It should be added that such a number of beds and profiles significantly relieves inpatient facilities at city hospitals and makes it possible to provide round-the-clock medical care to those patients who really need it.

The program for the development of hospital-replacement technologies has been in effect for two and a half years, and during this time 834 beds have been opened in the district. An additional 60 beds are planned to open this year.

It is important to note that in order to provide specialized medical care for elderly patients, in the very near future we will open 10 gerontological beds in branch No. 2 of city clinic No. 166 (former clinic No. 148). For those elderly patients who require round-the-clock medical care, there are departments nursing care. They operate on the basis of city hospitals No. 4 and 56. In city hospital No. 56, the department was opened only in January of this year, and is only 15-20% occupied, so the district does not experience a shortage of beds. To receive a referral for treatment to the nursing department, you need to contact your attending physician, he will tell you in detail about the procedure for hospitalization.

The district also provides home medical care for those patients who are unable to move independently. This is the so-called hospital at home, where doctors provide all necessary help at home.

The municipal service includes examination and treatment in a day hospital.
Municipal services are provided free of charge as part of the compulsory health insurance program if you have a compulsory health insurance policy on a scheduled basis.

Emergency medical care is not provided in the day hospital.
Recipients of the service are individuals who applied to the day hospital for medical care within the framework of compulsory health insurance
The purpose of providing municipal services is to provide qualified primary health care in a day hospital setting.
The duration of the service depends on the severity of the disease (diagnosis).

To receive municipal services, the applicant must submit:

1. Identity document (to be presented):
- passport of a citizen of the Russian Federation;
- birth certificate.
2. Compulsory medical insurance policy of the Russian Federation.
3. Referral from the attending physician.

To receive a municipal service, the applicant:
- makes an appointment with the head of the department or the DS doctor for an initial examination;
- provides documents;
- is registered in the DS or receives a reasoned refusal;
- complies with the doctor’s instructions and prescriptions;
- attends prescribed procedures;
- undergoes prescribed clinical diagnostic examinations;
- complies with the DS regime in accordance with the procedure established by the chief physician of the clinic;
- upon completion of treatment, receives a statement from the attending physician with further recommendations.

Waiting time in queue:

For hospitalization in the day hospital of the State Budgetary Healthcare Institution for up to 30 days (depending on availability)
- treatment in a day hospital depending on the diagnosis and course of the disease.

Grounds for refusal of admission:
- lack of a compulsory medical policy;
- lack of an identity document;

Grounds for refusal to provide services:

Presence of contraindications;
- lack of indications for day hospital;
- the applicant’s refusal to receive treatment;

GENERAL INDICATIONS FOR HOSPITALIZATION IN A DAY HOSPITAL

The following patients can be referred for treatment to the day hospital of the clinic:
- those who are registered at the dispensary for vegetative-vascular dystonia (VSD) and biliary dyskinesia (BDSD), and who do not require round-the-clock monitoring and use due to their health status medicinal products, after use, which should be under medical supervision for a certain time due to possible adverse reactions;
- requiring intravenous drip administration medicines;
- those in need complex treatment using physiotherapy, massage, physical therapy, after which rest is necessary, as well as when administering medications different ways at certain intervals.

GENERAL CONTRAINDICATIONS FOR HOSPITALIZATION IN A DAY HOSPITAL

Staying in a day hospital is contraindicated for patients:
- those in need of round-the-clock medical supervision and medical care, parenteral round-the-clock administration of medications; requiring bed rest;
- having severe concomitant disease, a complication of the underlying disease that developed during treatment in a day hospital;
- with frequent exacerbations at night until the condition stabilizes;
- with sharply disabilities independent movement;
- conditions that require strict adherence to a dietary regimen, and which cannot be fulfilled in a clinic setting;
- health and condition that may worsen when exposed to cold air, heat on the way to the day hospital and home.

INTERNAL RULES OF THE DAY HOSPITAL

The patient is obliged:
- take care of your own health, take timely measures to preserve, strengthen and restore it;
- treat healthcare workers and other patients with respect;
- follow recommendations medical workers necessary to implement the chosen treatment tactics, cooperate with medical professionals in the provision of medical care;
- inform medical workers about the presence of diseases that pose a danger to public health, the human immunodeficiency virus, and also take precautions when contacting other persons;
- inform medical workers about previously identified medical contraindications to the use of medications, hereditary and transmitted diseases, requests for medical help, as well as changes in health status;
- follow the internal rules of the clinic and treat property with care.

HOSPITALIZATION PROCEDURE IN A DAY HOSPITAL

Hospitalization is carried out as planned.
The patient must have an outpatient card and a referral from a doctor for hospitalization in a day hospital, a change of clothes and shoes.
In case of refusal (from) hospitalization, the doctor of the day hospital makes a record in the register of patient admissions and refusals to hospitalize the reasons for the refusal to hospitalize and measures taken with written information from the patient.
The treatment plan (start date of treatment, duration of treatment, examination methods, time of arrival and duration of stay in a day hospital, etc.) of a patient in a day hospital is determined by a day hospital doctor for each patient individually.
The patient is discharged after 12.00.
Before discharge from the day hospital, a final examination of the patient is carried out by a doctor at the day hospital, and, if necessary, by a specialist doctor at the clinic who referred the patient to the day hospital.
On the day the patient leaves the day hospital outpatient card is transferred to the attending physician through the registry with a completed epicrisis.
The first copy of the epicrisis is pasted into the patient’s outpatient medical record, the second copy remains in the patient’s day hospital record.
After the patient’s departure from the day hospital, a patient’s card from the day hospital is drawn up within 3 days and stored in the archives of the day hospital.
In case of conflict situations, the patient has the right to contact the administration of the clinic in accordance with the schedule of reception of citizens approved by the chief physician of the clinic.

Brain Clinic provides inpatient treatment using replacement methods; for this purpose, we have organized intensive therapy on the clinic premises and at home. Was organized " Day hospital».

Brain Clinic doctors with extensive experience in treatment various diseases nervous system and dependencies within medical procedures in the conditions of the “Day Hospital”, active therapy is carried out according to special, individually selected therapeutic methods, correctly and safely restoring a person’s neuropsychic activity without any side and negative influences on the body.

Call +7 495 135-44-02

We help in the most severe cases, even if previous treatment did not help. Treatment at the clinic is guaranteed on an anonymous basis.

Day hospital

The main task of the day hospital at Brain Clinic is intensive outpatient outpatient care in a polyclinic setting. This usually includes: mandatory examination by a doctor, if necessary medication assistance(drips, injections, issuing tablets to take at home), psychotherapy and physiotherapeutic procedures are carried out if necessary. We understand “day hospital” and offer a highly effective hospital-replacement program in outpatient care settings.

A full-cycle day hospital, which is regulated by the Ministry of Health, involves the patient staying on the clinic premises for 6-12 hours. We, on the basis scientific developments, were able to significantly reduce the length of stay of the patient in the day hospital, and not only did not lose quality, but on the contrary, due to a specific approach to healing process, improve the quality of treatment provided.

In cases where conventional outpatient (that is, at home) treatment does not help and therapy is needed in a hospital setting, but the patient does not have the opportunity to be hospitalized (fear of the hospital, no opportunity to leave work, school, no one to leave the children with, etc.) .d.), then a day hospital is a good opportunity not to be left without the necessary help.

Day hospital allows patients to undergo active treatment without hospitalization, while maintaining the opportunity to continue working or studying.

Brain Clinic has the ability to provide intensive and highly effective therapy in a “day hospital” setting (outpatient care).

Treatment provided in a day hospital

Brain Clinic has developed uniquely effective treatment methods neurological diseases, mental disorders, neuroses, depression, insomnia, headaches and other nervous system disorders, which avoid hospitalization in more than 80% of cases. This allows not only to save the patient money on treatment, but also to improve the quality of medical interventions. This opportunity arose thanks to a combination of advanced methods of biological treatment (drug and physiotherapy) and active psychotherapeutic assistance. At Brain Clinic, it is possible to provide treatment in a day hospital setting for almost every disease.
Treatment in a day hospital is often used to continue therapy started in a 24-hour hospital, which can significantly reduce the length of hospitalization. After docked acute condition, the basic functions of the body have been stabilized (consciousness has been restored, a critical attitude to one’s condition has been developed, hemodynamic parameters have normalized), the patient can be transferred from a 24-hour hospital to a day hospital. This form of continuation of treatment not only contributes to the socialization of the patient, but also accelerates the recovery process. In order to begin treatment in a day hospital, you need to contact the Brain Clinic for a consultation with a doctor, the doctor will clarify the condition and determine both indications and contraindications for certain inpatient replacement treatment methods. In addition, you can get to the day hospital at the Brain Clinic by referral from any doctor.
The cost of treatment in a day hospital at Brain Clinic is 5,000 rubles per session of outpatient care using hospital-substituting methods, with the average price of hospital treatment being 10,000 rubles per day.

Time spent in day hospital

The length of stay in a day hospital can be from one to several hours, depending on the severity of the disease and the number of necessary procedures. During this time, a consultation with a doctor or several specialists is carried out with an assessment of the state of the nervous system and physical condition, doctor’s prescriptions are made and carried out (intravenous and/or intramuscular infusions, tablet medications are given to take during the day, physiotherapy, psychotherapy, etc.).

Time of visiting the day hospital

At the Brain Clinic it is possible to visit the day hospital at a time convenient for the patient and his loved ones. In most cases, it is advisable to schedule visits to the day hospital so that the visiting time is at the same time. This may have a more favorable effect on treatment results.
A distinctive feature of the Brain Clinic day hospital is that this form of treatment can be completed regardless of weekends and holidays. At the same time, the cost of a day hospital does not change.

Type of day hospital

The Brain Clinic provides active treatment without round-the-clock hospitalization using hospital-substituting methods in various modes: “weekend day hospital” and “daily day hospital”. Which is agreed with the attending physician and, if necessary, in accordance with existing health problems.

Weekend day hospital

For patients who are indicated for active treatment, but who, due to work (study) or distance, are unable to visit the clinic on weekdays, Brain Clinic offers a weekend day hospital. This is outpatient care provided on weekends. Such patients undergo active therapy on weekends ( intravenous infusions, intramuscular injections, physiotherapy), and on weekdays - supportive (for example, taking tablet forms).

Daily day hospital

In this mode, the patient comes to the clinic to receive daily intensive care. This mode is necessary for hospital replacement techniques, when daily monitoring of the patient’s condition is required and the most intensive therapy. The visit can be scheduled at any convenient time. During the day you can go about your business (study, work, etc.). However.

Features of the day hospital at the Brain Clinic

  • Wide selection of day care forms
  • Patient support by phone
  • Free medication for 24 hours
  • Constant condition monitoring

All indications and contraindications for treatment in a day hospital, weekend day hospital and daily hospital are determined by the attending physician based on the person’s condition. If you have any questions, please contact us by phone.

The portal provides information about which hospitals and medical centers in Moscow have day hospitals for patients. For your convenience, we have collected telephone numbers and addresses of clinics, prices for the most popular services, as well as hospital costs day stay, patient reviews. To make your search easier, we have developed a visual filter for metro stations and districts, allowing you to quickly select the optimal option by location.

A day hospital in a clinic or medical center is intended for rehabilitation and preventive measures patients who do not require 24-hour medical supervision. It has all the necessary equipment to provide the full range of procedures for inpatient treatment: infusions, intramuscular and intravenous injections, ozone therapy, intravenous laser therapy, ultraviolet blood purification, oxygen procedures and many other services.

Advantages of treatment in a day hospital at medical centers in Moscow

First of all, these include the availability of all the necessary modern tools for quick and accurate diagnosis patient's condition. For their outpatient use, patients would have to spend a lot of time getting a doctor's referral, visiting a medical center and waiting in queues. By visiting adult and children's day hospitals, you can receive the full range of inpatient treatment.

No less important is the factor of constant and vigilant monitoring by doctors - in this case, the patient’s recovery occurs faster. The high qualifications of the clinic’s specialists also play a significant role in this, thanks to which they promptly correct the prescribed treatment and refer the patient for additional diagnostics, prescribe new examinations or tests.

The therapeutic hospital sometimes combines traditional healing methods and the latest developments. Thus, patients with diseases of the heart, lungs, nervous system and other problems receive more effective treatment rather than prescribing medications for home use.

Why is a day hospital needed in a hospital?

The organization of a day hospital is aimed at providing qualified diagnostic, therapeutic and rehabilitation care to patients who require inpatient treatment, but do not need round-the-clock medical supervision. In addition, the day hospital is aimed at:

  • Providing a range of examinations and treatment for patients who cannot be hospitalized in a medical center or hospital for a number of social reasons.
  • Providing advisory, diagnostic and therapeutic assistance for patients who do not require constant monitoring.
  • Planned health improvement of patients included in the dispensary group.
  • Planned health improvement and treatment courses for individual groups of patients.
  • Continuation of treatment of patients who have completed hospital treatment.
  • Providing emergency assistance for those patients who have emergency conditions when visiting a medical facility.
  • Improving the level and increasing the prestige of the medical institution.
  • Ensuring greater accessibility of inpatient care through more rational use of bed capacity in 24-hour hospitals and reducing costs medical center for the treatment of patients.

To reduce the time of examination of patients and the opportunity to prescribe treatment at an early stage, patients are often referred for hospitalization based on the results of preliminary general clinical examinations and according to the indications of specialist doctors.

Regulations on the organization of day hospital activities in medical and preventive institutions

General provisions

1. Regulations on day care.

1.1. A day hospital is a diagnostic and treatment department that is part of a medical and preventive institution, including outpatient clinics, hospitals, and clinics of medical educational institutions.

1.2. The day hospital is intended for preventive, diagnostic, therapeutic and rehabilitation activities patients who do not require round-the-clock medical supervision, using modern medical technologies in accordance with standards and protocols for patient management.

1.3. In its activities, the day hospital of a medical institution is guided by the legislation of the Russian Federation, regulatory legal acts of the Ministry of Health and Social Development of the Russian Federation, health authorities of the constituent entities of the Russian Federation, the Program of State Guarantees for providing citizens of the Russian Federation with free medical care, the Order on staffing standards medical personnel No. 000 of 1979, SanPiN 2.1.3.1375-03 and these Regulations.

1.4. The bed capacity and profile of a day hospital are determined by the head of the medical and preventive institution in which it was created, in agreement with the relevant health care authority, taking into account the existing health care infrastructure, as well as the morbidity of the population.

In accordance with the profile, day care beds are a structural part of the department (ward) bed capacity.

The capacity of a hospital is determined by the number of round-the-clock and day-care beds.

Registration of day care beds in hospitals and the movement of patients is carried out in accordance with the established procedure.

The procedure for referral and hospitalization to a day hospital, the conditions for discharge or transfer to a medical institution are approved by the head of the medical institution.

The operating hours of the day hospital are determined by the head of the medical institution, taking into account the volume of medical activities carried out in 2 shifts; if necessary, work in 3 shifts is possible.

Medical and drug assistance to the population in a day hospital is provided within the framework of the territorial Program of State Guarantees for providing citizens of the Russian Federation with free medical care, as well as on the terms of voluntary medical insurance or paid medical services in accordance with the current legislation of the Russian Federation.

In day care units at hospitals, the number of medical staff positions is determined according to the current staffing standards provided for departments of the corresponding profile. Meals in the drug treatment, psychiatric, phthisiatric, psychoneurological and pediatric departments of the day hospital are provided at the expense of the medical institution. Two meals a day.

Patients are admitted to the day hospital from doctors' offices outpatient facility, prevention departments, specialized institutions, as well as from hospitals.

In the day hospital, established medical records and reports are maintained:

Medical record of an inpatient (form 003-u);

Journal of admission of patients and refusals of hospitalization (form 001-u);

List of medical prescriptions;

The book for issuing certificates of incapacity for work (form 036-u) is located in the office “Med. Part";

Card of a patient being treated in the physiotherapy department (form 044);

Journal of procedures (form 029-u);

Notice of side effect medicinal product(form 093-у);

Transfusion media transfusion registration sheet (form 005-u);

Journal of registration of transfusion of transfusion media (form 009-u);

Log entry surgical interventions(form 008-у);

Statistical card of a person leaving the hospital (form 066);

Sheet for recording the movement of patients and hospital beds (form 007-u);

The activities of the day hospital are carried out in accordance with the work plan approved by the administration of the institution.

The management of the day hospital is carried out by the head (in the absence of a vacated position - by the chief physician or one of his deputies).

1.11 Control over the activities of the day hospital is carried out by the head of the medical institution and (or) the deputy for medical affairs and the clinical expert commission of the medical institution.

1.12. The day hospital has internal rules for patients, approved by the head of the institution.

1.13.Equipping a day hospital with medical equipment, instruments and dressings is carried out at the expense of medical institutions and attracted funds from industrial enterprises, institutions and organizations.

1.14. Examination, treatment and follow-up treatment in a day hospital are carried out with extensive use of the capabilities of diagnostic and treatment units based on the interaction and interrelation of doctors of these units.

1.15. Consultation of patients in day hospitals is carried out by specialists from this institution.

1.16. The organization and liquidation of a day hospital is carried out by decision of the head of the medical institution in agreement with the relevant health authority.

2. Regulations on hospitalization at home.

2.1. Inpatient care at home provides medical care at home.

2.2. Inpatient care at home is organized on the basis of a medical and preventive institution:

Outpatient clinic;

Women's consultation;

A specialized dispensary is its structural unit.

2.3. Observation and treatment of patients in a hospital at home is carried out by a local therapist, medical specialist, and local medical officer. clinic nurse.

2.4. Medical institutions, the structural unit of which is a hospital at home, provides the doctor with transport.

2.5. The management of a hospital at home can be carried out by one of the managers therapeutic department(clinic, hospital), who visits the patient at home 1-2 times during the treatment period in order to monitor the quality of diagnosis and correct treatment.

2.6. The selection of patients for inpatient treatment at home is carried out by the attending physician of a hospital or outpatient clinic in agreement with the head of the department.

2.7. The following are subject to inpatient treatment at home:

· patients discharged from the hospital to complete the course of therapy in their home bed under the supervision of a physician;

· moderately severe and severely ill patients with no indications for hospitalization in a 24-hour hospital, such as:

Threat to the patient's life: acute cardiovascular failure, acute respiratory failure, acute liver failure, spicy renal failure, acute disorder cerebral circulation, shock of various etiologies, acute poisoning, coma of various etiologies, acute myocardial infarction;

The threat of the above violations occurring on the first day;

The need for constant medical supervision;

Inability to carry out diagnostic and therapeutic measures in outpatient settings;

The need to perform treatment procedures around the clock;

Isolation for epidemiological reasons;

Threat to the life and health of others.

· patients who need rehabilitation treatment when it is impossible to carry it out on an outpatient basis;

· patients with chronic diseases for planned treatment.

2.8. The inpatient at home uses in its work all the advisory, treatment and diagnostic services available in the treatment and preventive institution.

2.9. The operating hours of a hospital at home are established by the head of the institution in accordance with the needs of the population for this type of care and local conditions.

2.10. To adjust the treatment and extend the temporary disability certificate, a clinical expert commission is held at home within the time frame specified established by law on examination of temporary disability.

2.11. A report on the activities of hospitals at home is submitted in the prescribed manner and within the established time frame.

2.12. Duration working week doctor and hospital nurse at home is 38.5 hours.

2.13. On the weekend, holidays Inpatient appointments at home are performed by nurses on duty at an outpatient clinic; seriously ill patients are examined by the hospital doctor on duty.

2.14. If the patient's condition worsens, he develops life-threatening conditions or the need for round-the-clock medical supervision, the patient is transferred to a round-the-clock hospital.

2.15. The length of stay of a patient in a hospital at home is determined by the patient’s condition, on average 12 days, for gerontological patients - 14 days.

2.16. Payment for treatment of patients is made at the expense of the compulsory medical insurance fund upon presentation of invoices for services provided. medical services according to the profile of patients treated or at the expense of the budget.

Purpose and functions

1.1. The purpose of the day hospital is to improve the quality of medical care in outpatient clinics and inpatient conditions, as well as increasing the economic efficiency of medical institutions based on the introduction and widespread implementation of modern resource-saving medical technologies for prevention, diagnosis, treatment and rehabilitation.

1.2. In accordance with this goal, the day hospital performs the following functions:

1.2.1 Selection of adequate therapy for patients with a newly diagnosed disease or chronic patients with an exacerbation of the process, a change in the severity of the disease.

1.2.2 Conducting a comprehensive course of treatment using modern medical technologies for patients who do not require round-the-clock medical supervision.

1.2.3. Implementation of rehabilitation and health complex course treatment for sick and disabled people, pregnant women.

1.2.4. Reducing the incidence of morbidity with temporary disability.

1.2.5. Conducting an examination of the state of health, the degree of disability of citizens and resolving the issue of referral for a medical and social examination.

1.2.6. Carrying out comprehensive preventive and health measures for people at risk of increased morbidity, including professional ones, as well as those who are sick for a long time and often.

Hospital at home.

2.1 The purpose of the work of a hospital at home is to improve the quality of provision of qualified and specialized assistance patients staying at home, development and improvement of new treatment methods aimed at developing out-of-hospital care and resource-saving technologies.

2.2. In accordance with this goal, the hospital at home performs the following functions:

2.2.1. Diagnosis and treatment of diseases in accordance with indications for hospitals at home.

2.2.2. Aftercare of patients after the stage of intensive treatment using modern means and methods of out-of-hospital medical care.

2.2.3 Relationship and continuity with various treatment and preventive social security institutions.

Structure and staff

Day hospital on the basis of outpatient clinics and hospitals

3.1. The structure of a day hospital may include:

· wards equipped necessary equipment and inventory;

· treatment room;

2.7. Label cleaning equipment, ensure its safety and keep it in a designated place.

3. Rights

A nurse at a day hospital has the right to:

3.1. Require visitors to maintain cleanliness and order in the premises.

3.2. Make demands on the head of the day hospital to create the necessary conditions for the performance of their duties.

4. Performance appraisal and responsibility

The assessment of the work of a nurse at a day hospital is carried out by the manager, doctors and a nurse responsible for the sanitary and hygienic condition of the day hospital based on an analysis of her performance of her functional duties, compliance with internal regulations, and labor discipline.

The day hospital nurse is responsible for poor performance of the duties provided for in this job description.

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