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 al point out one major conceptual error in the United Kingdom's version: it aims at relieving an administrative problem—namely, excessive bed occupancy.1 They did not deal with the patient's perspective. To achieve change four issues need to be addressed, in sequence. What is needed? How can that need be met? Who can meet it? Who pays?

Patients' needs relate partly to the underlying pathological process.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 neurone disease), or relapse and remission (for example, rheumatoid arthritis).3 Recovering patients may require intensive or slow rehabilitation as inpatients to facilitate returning home. For patients with deteriorating conditions, community based teams, which work in the patient's own home and liaise closely with community 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]

Rapid Responses:

Read all Rapid Responses

Intermediate Care & Rehabilitation
Peter K Tun
bmj.com, 17 Sep 2004 [Full text]
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