What is intermediate care?: A flawed substitute for rehabilitation in the United Kingdom

doi:10.1136/bmj.329.7467.686-b

BMJ 2004;329:686 (18 September), doi:10.1136/bmj.329.7467.686-b

Letter

What is intermediate care?

A flawed substitute for rehabilitation in the United Kingdom

The first 150 words of the full text of this article appear below.

EDITOR—In asking what is intermediate care Melis et alpoint out one major conceptual error in the United Kingdom'sversion: it aims at relieving an administrative problem—namely,excessive bed occupancy.¹ They did not deal with the patient'sperspective. To achieve change four issues need to be addressed,in sequence. What is needed? How can that need be met? Who canmeet it? Who pays?

Patients' needs relate partly to the underlying pathologicalprocess.² Some are born with disabilities or acquire them early.Acquired illness in adult life may have expectations of improvement(for example, trauma), progression (for example, motor neuronedisease), or relapse and remission (for example, rheumatoidarthritis).³ Recovering patients may require intensive or slowrehabilitation as inpatients to facilitate returning home. Forpatients with deteriorating conditions, community based teams,which work in the patient's own home and liaise closely withcommunity agencies (educational, social, vocational), are . . . [Full text of this article]

Andrew O Frank, consultant physician in rehabilitation medicine and rheumatology

Northwick Park Hospital and Harrow Primary Care Trust, Harrow HA1 3UJ Andrew.frank1@btinternet.com

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Relevant Article

What is intermediate care?: René J F Melis, Marcel G M Olde Rikkert, Stuart G Parker, and Monique I J van Eijken
BMJ 2004 329: 360-361. [Extract] [Full Text] [PDF]