Rehabilitation of the patient with chronic critical illness

Thomas, David C.; Kreizman, Isaac J.; Melchiorre, Philip J.; Ragnarsson, Kristjan T.

doi:10.1016/s0749-0704(02)00011-8

Cited by 37 publications

(38 citation statements)

References 43 publications

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“…Despite the rapid growth of LTCHs, little is still known about the quality of results and difficulty of weaning from mechanical ventilation (29). Therefore research commenced into how costs could be reduced for the care of patients requiring long-term acute care (28,29). In 1982, with the Tax Equivalence and Financial Responsibility Agreement (TEFRA) and also LTCHs were designated by Medicare to form a specific payment method for LTC (28).…”

Section: General Features Of Ltchmentioning

confidence: 99%

“…Therefore research commenced into how costs could be reduced for the care of patients requiring long-term acute care (28,29). In 1982, with the Tax Equivalence and Financial Responsibility Agreement (TEFRA) and also LTCHs were designated by Medicare to form a specific payment method for LTC (28). By providing financial support to Medicare for the care of chronic critical patients since 1983, the Healthcare Financial Administration in the USA has enabled the opening of many LTCHs (30).…”

Section: General Features Of Ltchmentioning

confidence: 99%

“…By providing financial support to Medicare for the care of chronic critical patients since 1983, the Healthcare Financial Administration in the USA has enabled the opening of many LTCHs (30). Following the application of prospective payments by Medicare to acute hospitals in 1984, the payments made to PAC services grew rapidly (28). Most of this growth was to provide nursing services to care institutions and at home (28).…”

Section: General Features Of Ltchmentioning

confidence: 99%

“…Following the application of prospective payments by Medicare to acute hospitals in 1984, the payments made to PAC services grew rapidly (28). Most of this growth was to provide nursing services to care institutions and at home (28). Initially, a small percentage of the total Medicare expenses was allocated for LTCHs (28).…”

Section: General Features Of Ltchmentioning

confidence: 99%

“…Most of this growth was to provide nursing services to care institutions and at home (28). Initially, a small percentage of the total Medicare expenses was allocated for LTCHs (28). Over time, LTCHs have become one of the most rapidly growing segments of the healthcare system (31).…”

Section: General Features Of Ltchmentioning

confidence: 99%

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Long-term care hospitals in Turkey: a review

Dinçer

Kahveci

Döğer³

et al. 2017

East Mediterr Health J

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Centres de long séjour hospitaliers en Turquie : analyseUn centre hospitalier de soins de longue durée (CHSLD) est un établissement spécialisé accueillant des patients qui souffrent de graves problèmes de santé et nécessitent des soins continus et intensifs sans avoir à recourir à des méthodes diagnostiques complètes. Les CHLSD fournissent des soins prolongés et complexes ainsi que des soins de plaies dans la période qui suit la phase aigüe de la maladie. Aux États-Unis, lorsque le séjour en unité des soins intensifs est prolongé, les patients peuvent être transférés vers un CHSLD. Medicare recommande une période d'hospitalisation en CHSLD de plus de 25 jours. Le système des CHSLD en Europe est différent de celui qui est établi dans d'autres pays non-européens. On note par ailleurs des différences entre les pays européens eux-mêmes. Dans la pratique, les patients qui ont besoin de soins de longue durée en Turquie sont hospitalisés en unités de soins intensifs. Le concept des soins de longue durée est nouveau dans le système de santé turc et il n'y existe pas d'études sur les CHSLD. Une proportion importante des lits réservés aux unités de soins intensifs en Turquie sont utilisés pour les soins de longue durée aux patients atteints de problèmes complexes. ABSTRACT A long-term care hospital (LTCH) is a specialized facility for patients with serious health problems who require continuous and intensive care but not comprehensive diagnostic methods. LTCHs provide prolonged complex care and wound care in the period following the acute stage of disease. When intensive care unit (ICU) stay is prolonged in the United States of America, the patients may be transferred to an LTCH. Medicare suggests hospitalization > 25 days in LTCHs. The LTC system in Europe differs from that in other non-European countries and differences are also seen among European countries. In practice, patients who need LTC in Turkey are hospitalized in ICUs. Long term care is a new concept for the Turkish health system and there are no studies on LTCHs in Turkey. A significant proportion of intensive care beds in Turkey are used for long-term hospitalized patients with complex problems. This is a clear waste of resources. The establishment of LTCHs in Turkey would prevent from this waste and provide the opportunity to increase experience of complex treatments.

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Section: General Features Of Ltchmentioning

confidence: 99%

Section: General Features Of Ltchmentioning

confidence: 99%

Section: General Features Of Ltchmentioning

confidence: 99%

Section: General Features Of Ltchmentioning

confidence: 99%

Section: General Features Of Ltchmentioning

confidence: 99%

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Long-term care hospitals in Turkey: a review

Dinçer

Kahveci

Döğer³

et al. 2017

East Mediterr Health J

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Rehabilitation in the Intensive Care Unit

Satti

Derr

Fornek

2010

Critical Care Study Guide

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Physiotherapy for adult patients with critical illness: recommendations of the European Respiratory Society and European Society of Intensive Care Medicine Task Force on Physiotherapy for Critically Ill Patients

Gosselink

Bott²,

Johnson³

et al. 2008

Intensive Care Med

602

419

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The Task Force reviewed and discussed the available literature on the effectiveness of physiotherapy for acute and chronic critically ill adult patients. Evidence from randomized controlled trials or meta-analyses was limited and most of the recommendations were level C (evidence from uncontrolled or nonrandomized trials, or from observational studies) and D (expert opinion). However, the following evidence-based targets for physiotherapy were identified: deconditioning, impaired airway clearance, atelectasis, intubation avoidance, and weaning failure. Discrepancies and lack of data on the efficacy of physiotherapy in clinical trials support the need to identify guidelines for physiotherapy assessments, in particular to identify patient characteristics that enable treatments to be prescribed and modified on an individual basis. There is a need to standardize pathways for clinical decision-making and education, to define the professional profile of physiotherapists, and increase the awareness of the benefits of prevention and treatment of immobility and deconditioning for critically ill adult patients.

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Rehabilitation of the patient with chronic critical illness

Cited by 37 publications

References 43 publications

Long-term care hospitals in Turkey: a review

Long-term care hospitals in Turkey: a review

Rehabilitation in the Intensive Care Unit

Physiotherapy for adult patients with critical illness: recommendations of the European Respiratory Society and European Society of Intensive Care Medicine Task Force on Physiotherapy for Critically Ill Patients

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