Inpatient care is the care of
patients whose
condition requires admission to a
hospital. Progress in modern medicine and the advent of comprehensive
out-patient clinics ensure that patients are only admitted to a hospital when they are extremely ill or have severe physical
trauma
Trauma most often refers to:
*Major trauma, in physical medicine, severe physical injury caused by an external source
*Psychological trauma, a type of damage to the psyche that occurs as a result of a severely distressing event
*Traumatic inju ...
.
Progress
Patients enter inpatient care mainly from previous
ambulatory care such as referral from a
family doctor, or through
emergency medicine departments. The patient formally becomes an "
inpatient" at the writing of an
admission note. Likewise, it is formally ended by writing a discharge note.
Planning for patient discharge
Health care professionals involved in rehabilitation are often involved in discharge planning for patients. When considering patient discharge, there are a number of factors to take into consideration: the patient's current state, their place of residence and the type of support available. When considering the patient's current state, although the patient may be eligible for discharge it is important to examine factors such as the likelihood of re-injury to avoid higher health care costs. Patients' homes should also be visited and examined before they are discharged from the hospital to determine any immediate challenges and corresponding goals, adaptations and assistive devices that need to be implemented. Follow-up appointments should also be coordinated with the patient prior to discharge to monitor the patient's progress as well as any potential complications that may have arisen.
A 2016
Cochrane Cochrane may refer to:
Places Australia
*Cochrane railway station, Sydney, a railway station on the closed Ropes Creek railway line
Canada
* Cochrane, Alberta
* Cochrane Lake, Alberta
* Cochrane District, Ontario
** Cochrane, Ontario, a town wit ...
review showed some benefit to patient health when using individualised discharge planning over a standard format, though no reduction in health care costs.
History
Inpatient care goes back to 230 BC in India where
Ashoka founded 18 hospitals. The
Romans also adopted the concept of inpatient care by building a specialized temple for sick patients in 291 AD on the island of
Tiber
The Tiber ( ; it, Tevere ; la, Tiberis) is the third-longest river in Italy and the longest in Central Italy, rising in the Apennine Mountains in Emilia-Romagna and flowing through Tuscany, Umbria, and Lazio, where it is joined by th ...
.
It is believed the first inpatient care in North America was provided by the
Spanish in the
Dominican Republic
The Dominican Republic ( ; es, República Dominicana, ) is a country located on the island of Hispaniola in the Greater Antilles archipelago of the Caribbean region. It occupies the eastern five-eighths of the island, which it shares with ...
in 1502; the
Hospital de Jesús Nazareno in
Mexico City
Mexico City ( es, link=no, Ciudad de México, ; abbr.: CDMX; Nahuatl: ''Altepetl Mexico'') is the capital and largest city of Mexico, and the most populous city in North America. One of the world's alpha cities, it is located in the Valley o ...
was founded in 1524 and is still providing inpatient care.
Perhaps the most famous provider of inpatient care was
Florence Nightingale
Florence Nightingale (; 12 May 1820 – 13 August 1910) was an English social reformer, statistician and the founder of modern nursing. Nightingale came to prominence while serving as a manager and trainer of nurses during the Crimean War ...
who was the leading advocate for improving medical care in the mid-19th century.
Nightingale received notoriety during the
Crimean War
The Crimean War, , was fought from October 1853 to February 1856 between Russia and an ultimately victorious alliance of the Ottoman Empire, France, the United Kingdom and Piedmont-Sardinia.
Geopolitical causes of the war included the ...
where she and 38 women volunteer nurses traveled to Crimea to treat wounded soldiers. During her first winter at the hospital 4077 soldiers died in the hospital there. She would use this experience to change the course of inpatient care by focusing on improving sanitary conditions and better living conditions within the hospital.
Nightingale became known as "The Lady with the Lamp" and is still considered the founder of modern nursing. The
Nightingale School of Nursing continues today and her image is the one depicted each year on nurses' day.
Hospitalist medicine
The original model for inpatient care required a
family physician to admit a patient and then make
rounds and manage the patient's care during their hospital stay. That model is rapidly being replaced by
hospitalist medicine a term first used by
Robert Wachter in an article written for
''The'' ''New England Journal of Medicine'' in 1996.
The concept of hospitalist medicine provides around the clock inpatient care from physicians whose sole practice is the hospital itself. They work with the community of primary care physicians to provide inpatient care and transition patients back to the care of their primary care provider upon discharge. Using this approach, primary care physicians are no longer required to make rounds or be on call.
Today, hospitalist medicine is the fastest growing segment of medicine and is being adopted by hospitals worldwide for inpatient care.
Statistics
In 2011, there were approximately 39 million inpatient stays in the United States, with a national aggregate cost of $387 billion. U.S. programs
Medicare and
Medicaid bore responsibility for 63 percent of these total aggregate costs.
In 2011, approximately one quarter of hospital stays in the United States were in the intensive care unit; these accounted for nearly half the aggregate total hospital charges that year.
See also
*
Medical observation, a type of care that takes place at the hospital as an outpatient
References
{{DEFAULTSORT:Inpatient Care
Types of health care facilities
Hospital departments