E. Lilin
A. Nosko
A. Sharandak
L. Rudnitskaya |
THE ORGANIZATION OF WORK OF THE DAY-TIME HOSPITAL
ON THE BASIS OF THE REHABILITATION CENTER |
| Federal State Institution “Russian Rehabilitation
Center “Detstvo”, Moscow, Russia |
For last years the tendency to stabilization of a level of the neurologic disease
leading proof restriction of opportunities among the children’s population
aged between 0 and 17 years is marked. Results of special researches testify,
that from 50% up to 70% given contingents of the patients receiving rehabilitation
in hospitals, could receive effective and thus much less expensive regenerative
treatment in conditions of day-time hospitals. The purpose of the given research
is to study an overall performance of day-time hospital, organized on the basis
of Federal State Institution “Russian Rehabilitation Center “Detstvo”,
for children with a various psycho-neurologic pathology. The structure of a
day time hospital corresponds to the standards developed in view of an operational
experience of stationary psycho -neurologic branches of the Center. The branch
is designed on 28 beds. As a leading method of treatment we apply a method of
“conductive education” in a combination with modern rehabilitation
technologies. In a day-time hospital principles of a complex approach and integration
(joint rehabilitation of patients with movement disorders and patients with
mental retardation) are implemented. During the work since November 2005 till
June 2007 on the basis of the day-time hospital 549 children aged between 2
and 17 years (averagely 6,7±0,5) underwent the treatment, among them
316 patients with movement disorders of various etiology, and 233 - with mental
retardation. The basic rehabilitation work is carried out by a team of experts
which consists of a neurologist, a speech therapist, a psychologist and a “conductor”
(an expert on “conductive education”). The experts divide patients
on rehabilitation groups. Each group is supervised as a rule, by one “rehabilitation
team”. The estimation of the work results during November 2005 till June
2007 has shown, that the amount of patients with a heavy degree of movement
disorders decreased from 31,2% to 6%; and the number of patients with light
degree of movement disorders has increased from 27,3% up to 72,8%. A substantial
growth of the level of social adaptation is observed: 81,8% patients could move
independently, 51,5% - have mastered movements on a ladder, 87,9% used a toilet
bowl, 100% patients have learned to eat without assistance. Comparing the obtained
data with the results obtained at stationary psycho-neurological departments
of the Center no authentic difference in dynamics is found. Thus, introduction
of the given practice of treatment of neurological patients at a day-time hospital
allows: to raise economic efficiency of a rehabilitation center, to improve
quality of rendering of medical aid, to lower a level of physical disability
among the children, to reduce conventional number of hospitalizations, not only
as a result of a higher efficiency of the treatment, but also due to development
of the program of out-patient treatment under the recommendation of experts
of a day-time hospital. The presented data allow speaking about expediency and
necessity not only to set up day-time hospitals based on rehabilitation centers,
but to open a whole network of day-time hospitals of a rehabilitation profile
for patients with a various psycho-neurologic pathology in regional and municipal
medicine institutions of the Russian Federation.
