Inappropriate acute neurosurgical bed occupancy and short falls in rehabilitation: implications for the National Service Framework.
Patients undergoing neurosurgical intervention may require different types of organized rehabilitation. A prospective study was performed of the care needs of neurosurgical inpatients between the ages of 16 and 70 years who were in acute wards for more than 2 weeks. Only 58% of bed occupancy days were devoted to essential acute neurosurgical ward management. This figure was even lower for patients admitted with subarachnoid haemorrhage (36%) or traumatic brain injury (38%). Overall, 21% of bed days would have more appropriately spent in 'rapid access'/acute rehabilitation beds, 13% in 'active participation' rehabilitation beds and 5% in cognitive/behavioural rehabilitation units. Addressing this unmet need would increase the availability of acute neurosurgery beds, without needing to build and staff more neurosurgery wards.
Bradley
L J
LJ
Department of Rehabilitation Medicine, Addenbrooke's Hospital, Cambridge, UK.
Kirker
S G B
SG
Corteen
E
E
Seeley
H M
HM
Pickard
J D
JD
Hutchinson
P J
PJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D001509:Bed Occupancy / Q000706:statistics & numerical data*; D006259:Craniocerebral Trauma / Q000534:rehabilitation*; D006301:Health Services Needs and Demand; D006801:Humans; D007902:Length of Stay; D008134:Long-Term Care / Q000706:statistics & numerical data; D008875:Middle Aged; D009313:National Health Programs; D009493:Neurosurgery / Q000706:statistics & numerical data*; D011446:Prospective Studies; D006113:United Kingdom