Editorials

What is intermediate care?

BMJ 2004; 329 doi: http://dx.doi.org/10.1136/bmj.329.7462.360 (Published 12 August 2004) Cite this as: BMJ 2004;329:360
  1. René J F Melis ([email protected]), researcher,
  2. Marcel G M Olde Rikkert, professor in geriatrics,
  3. Stuart G Parker, professor in geriatrics,
  4. Monique I J van Eijken, researcher
  1. Department of Geriatric Medicine, Internal Postal Code 318, University Medical Centre Nijmegen PO Box 9101, NL-6500 HB Nijmegen, Netherlands
  2. Sheffield Institute for Studies on Ageing, Barnsley District General Hospital, University of Sheffield, Sheffield S10 2TU
  3. Centre for Quality of Care Research (WOK), University Medical Centre Nijmegen, Geert Grooteplein 21, NL-6525 EZ, Nijmegen, Netherlands

    An international consensus on what constitutes intermediate care is needed

    Intermediate care is an emerging concept in health care, which may offer attractive alternatives to hospital care for elderly patients. As little scientific evidence exists on the benefits of intermediate care, research is especially important.13 A prerequisite for research is agreement on the definition of a concept, which is lacking for intermediate care. The term intermediate care is often used as if its meaning is clear, but it conveys little meaning other than being about care that is “in between.” Commonly used definitions of intermediate care do not help much, and several very different definitions are in use. What is needed at the outset is a consensus on what constitutes intermediate care. Until this is agreed on, the concept of intermediate care will remain a mirage and its possibilities unknown.

    The term intermediate care was introduced in the United Kingdom's NHS Plan and refined in the national service framework for older people.4 5 The concept seems to arise out of a policy imperative, rather than an analysis of the scientific evidence about effective models of care. Objectives such as “promotion of independence” and …

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