“Inpatient hospitalization makes sense for major diagnostic, surgical or therapeutic services, where the patient’s condition or response to medication must be closely monitored” as defined by the Hays Companies (n.d). Acute inpatient rehabilitation is a system that sponsors special rehab services for patients whose medical conditions demand they stay for more than one night or for a long-term stay. Patients suffering from a disease, disabled to self-reliance, or maximal efficient control are considered inpatient acute patients. This paper will identify and describe the acute inpatient rehabilitation setting; describe two trends that impact acute inpatient rehabilitation; assess the impact of these trends on the inpatient setting; and analyze the trends.
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Acute Inpatient Rehabilitation Setting
Conditions that require a patient to be in acute inpatient rehabilitation consist of; persons with compelling functional disabilities affiliated with brain injuries, stroke, or major trauma. Inpatient rehabilitation aim to employs an inter-disciplinary, systematized, team approach that requires a minimum of two hours rehabilitation services a day. Services provided include: speech therapy, physical therapy, respiratory therapy, cognitive therapy, and psychology services.
Acute inpatient rehabilitation is essential when an individual’s medical situation is such that the acuteness of services would not improve a temporary setting like an outpatient department. According to Health South Hospital (n.d), when it comes to rehabilitation for a disorder or wound, acute care rehabilitation hospitals provide better care than other inpatient settings. The setting for inpatient rehabilitation is particularly regulated by the individual’s functional and medical situation and the capability of the rehabilitation facility to accommodate the mandatory level of affection.
Two Trends Impacting the Setting
First Trend:
Patient Care
Patients admitted to inpatient rehabilitation hospitals often had a recent or a remaining significant impairment of a serious sickness or wound due to one or more medical condition. The impairments affect the patient’s ability to do activities of daily living. These patients are commonly dangerous when left unaccompanied without the assistance of others to support them through daily activities. Some of the Acute Inpatient rehabilitation setting needs to have characteristics that distinguish them from other stages of care, such as acute setting, and skilled nursing services.
Inpatient rehabilitation hospitals should offer higher medical assistance, a large number of nursing, additional rehabilitation therapies and many other services on a severe basis which is some inpatient rehabilitation hospitals lack because of the lack of staff members. Several inpatient rehabilitation settings lack the accessibility of a gym, dining services and other services that are not commonly found in other inpatient setting. Some of the Acute Inpatient rehabilitation setting needs to have characteristics that distinguish them from other stages of care, such as acute setting, and skilled nursing services. The absence of the above services slows healing as it discourages patients from getting necessary help and engage in activities they can do after discharge.
One of the prime mistakes some of the rehabilitation therapist do is not showing empathy to the patient. Empathy is one of the most influential human responses to pain and sorrow. Pain alone, does not automatically call out empathy. Empathy is a dynamic hunt to see the pain and sorrow in another, and act on their behalf to diminish their sorrow. In the inpatient rehabilitation setting, this can lead to poor patient care. Allowing that empathy fatigue is a problematic and learning to identify its effects and manage its indications is the main step towards healing. Therefore, the impact of the characteristics in inpatient setting help discharge the patient, help the patient heal faster and understand the trouble in an open way.
Second Trend:
High Cost
Several inpatient rehabilitation services use Medicare insurance, which pays a certain amount of the cost for the patient. According to Medpac Chapter3 (2008, pg.49) “Acute inpatient payment system Medicare’s acute inpatient PPS (IPPS) pays hospitals a predetermined amount for most discharges. The payment rate is the product of a base payment rate and a relative…” However, the cost is still considered high and Medicare or other insurance companies in the eyes of a patient doesn’t pay what satisfies them.
According to Newswise (2012) there is a big decline in length of stay and inpatient admission because the cost of the hospital stay becomes higher each year. Employees quit their job due to increased hours more than the wages are increased, which does not encourage them to work in inpatient setting. Rising pharmaceutical cost is also one of the main problems most hospitals faces, the fees of most medications are high and most insurance companies only pay for specific medications.
Political issues also affect the cost of many inpatient rehabilitation settings. When the economy goes high, so does the cost of these hospitals, and when it’s down unfortunately the cost doesn’t go much down. Besides specific radical, market and price issues, more overall issues have been distinguished. Medicare and other insurance companies should have more options for those who can’t pay the whole amount especially for those who don’t have health insurance. Patients who need to be admitted to inpatient rehabilitation hospitals and can’t afford the fees, will choose not to be treated. Managers must realize that not only the essentials of these cost changes, but also how these changes will have an impact of the patient treatment options.
Analyzing the Trends
Patient care and cost have a positive and negative impact on inpatient rehabilitation setting. Providing the wrong treatment and the wrong medication can cause a negative impact on the patient care. Most patients choose to be discharged before completing the treatment because of the high amount rehabilitation centers. However these trends have a positive side as well which can improve in many inpatient rehabilitation settings and help the patient.
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Nurses and physicians with experience in inpatient rehabilitation setting in most hospitals are obligated to be available seven days a week, 24-hours. This includes physiatrists, or other physicians with knowledge of inpatient rehabilitation care, and nurses that are certified in rehabilitation nursing. The number of staff fellows has to be adequate to offer each patient with at least three hours of therapy every day and meet the rehabilitation needs. These characteristics will help the patients become better and stable.
-The results of these trends from these changes include:
*A decrease in a patient length of stay.
*A Reduced number of clinical facilities and services, including speech therapy, physical therapy, respiratory therapy, cognitive therapy, or psychology services.
*A reduced number of Staff.
*A loss of patients
In conclusion, inpatient rehabilitation is the place for patients that has to stay overnight and for those with compelling functional disabilities associated with brain injuries, stroke, and etc… Whether the impact of the trends in this rehabilitation setting is positive or negative, most patients will get treated in the right way and will be discharged once they have fully recovered. The cost could be a big problem for most patients but when a patient needs help and needs to be treated, inpatient rehabilitation setting is a good place for them to heal.
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