Six Types of Rehabilitation Settings Explained

Hospitals play a key role in a well-functioning healthcare referral network. Given the current external pressures, deficiencies in health systems and deficiencies in the hospital sector, which were exacerbated during the COVID-19 pandemic, this role has become increasingly important, in particular to support other healthcare providers within the community and services. Effective hospitals are designed for their users, paying attention to the needs of special populations, such as children and the elderly. A well-designed hospital environment maximizes the effectiveness of clinical care delivery and improves the well-being of both patients and hospital staff.

The general or district hospital is probably the most well-known type of hospital that people have access to. General hospitals are usually the first level of hospital care after referral from primary care services, or they can be the first point of care for immediate and urgent health threats through accident and emergency or trauma centers. They provide a wide range of services for patients of different age groups and with different conditions or injuries. Regional or provincial hospitals are different from smaller general hospitals and larger or specialized tertiary level hospitals, and the World Health Organization has defined them as a secondary level hospital offering at least 5 to 10 clinical specialties with 200 to 800 hospital beds.

Specialty hospitals are primarily and exclusively dedicated to one or more related medical specialties, including specialized trauma centers, rehabilitation hospitals, children's hospitals, geriatric hospitals, maternity hospitals and hospitals to treat specific medical needs, such as psychiatric and certain categories of diseases, such as cardiac, oncological, neurological, etc. Research suggests that specialized hospitals may reduce the total cost of medical care compared to general hospitals, which is believed to be the result of the limited number of procedures or interventions performed, allowing a specialist to be more efficient in providing services. According to the World Health Organization, specialized hospitals provide an effective and affordable health service for a defined population, in cooperation with primary and secondary health services, and also play a role in supporting other health services by providing a wide range of technical, educational and training for primary and secondary health care in relation to their specific area of specialty. In assisted living facilities, people of all ages live in a home environment with access to on-call care as needed or to 24-hour care in a number of areas, including meals, assistance with daily activities, such as dressing, going to the bathroom, taking medications, and health care services.

These facilities are designed to help people complete their daily activities as safely and independently as possible and to optimize function within their environment. Although it is not a specific rehabilitation environment, telehealth has grown exponentially in the area of rehabilitation, in particular during the COVID-19 pandemic, with restrictions on face-to-face intervention. As such, telehealth can represent a digital form of rehabilitation environment and is likely to remain in clinical use even as we emerge from the COVID-19 pandemic. Secondary care is generally provided in a general or regional hospital, predominantly in an inpatient setting, but can also be performed in an outpatient setting within the same hospital or within an alternative outpatient clinic.

Tertiary care is normally provided in a specialized hospital setting. Quaternary care is provided in highly specialized settings, usually within a specialized hospital, universities, and can also be performed in medical centers or private laboratories. You may have heard of rehabilitation centers before but did you know that there is more than one type? Depending on your loved one's needs you may need to go to a long-term care facility (LTAC), an inpatient rehabilitation center (IRC), or a skilled nursing facility (SNF). Here's some more information about each type: Long-term intensive care facilities (LTACs) are specialized hospitals designed for longer stays of 20 to 30 days.

The care offered at an LTAC is more intensive than at an IRC or SNF. Patients usually arrive after a hospital stay and require special care needs. Inpatient rehabilitation centers (IRCs) provide intensive therapy such as physical therapy (PT), occupational therapy (OT), speech and language therapy (SLT), prostheses and orthopedic appliances so that individuals can achieve optimal functioning within their environment. The average length of stay at an IRC is 1-2 weeks.

Some patients may not qualify for IRCs immediately because they need to regain strength before they can undergo intensive care. Skilled nursing facilities (SNFs) are sometimes referred to as nursing homes. They provide regular care by licensed nurses for those who don't have enough help at home or need to get stronger before returning home. Chronic health problems such as diabetes or lung/heart problems can be better managed at SNFs.

Care is available 24/7 with an average length of stay being 26 days. Each type of rehabilitation therapy can be accessed in various healthcare settings including IRCs, outpatient rehabilitation clinics (ORCs) and home rehabilitation services (HRS). In general rehabilitation centers were created to provide high-level professional therapy so that individuals can achieve optimal functioning within their environment.

Blanche Taboada
Blanche Taboada

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