title: [Waiting time between acute event and rehabilitation: continuity of nursing care and rehabilitation. Analysis and suggestions for a Service of Protected Discharge].
abstract: BACKGROUND
  In recent years, in Italy, population lengthening of life leads to an higher number of individuals with chronic diseases (Osservatorio, 2010). The hospital which deals with the acute phase of diseases needs to be integrated with primary care. This connection is particularly important for the treatment, care and rehabilitation of patient, as well as a general need for more health and social care integrated tools.
  
  
  OBJECTIVE
  At the San Gerardo Hospital in Monza, in the context of the patient's post-acute rehabilitation, we analyze the phase between discharge from hospital and the expected date of hospitalization in facilities providing rehabilitation. The aim of this observational descriptive study is to determine the distribution of days of waiting. Furthermore, several different approach are analysed (i.e. Integrated Home Care) in order to reduce unnecessary days hospitalization and a more intelligent and cost effective use of resources The research question are the follow, to quantify waiting time between discharge and hospitalization in the rehabilitation facility and to ascertain if patients are sent to the correct facility.
  
  
  RESULTS
  1083 individuals were taken into account, of those 55% (N=652) were discharged from the hospital later. This leads to a 4505 days of inappropriate hospitalization.
  
  
  CONCLUSIONS
  Although the use of home care could be beneficial to the hospital, this can be used only for tiny part of the patients and it is not cost effective. A possible solution can be set up a number of low cost bed entirely managed by nurses due to the low level of intensity care.
authors.affiliation: Coordinatrice infermieristica, Referente Servizio Dimissioni Protette, AO San Gerardo di Monza.
authors.forename: Ilaria
authors.initials: I
authors.lastname: D'Ilio
authors.affiliation: Dirigente SITRA, AO San Gerardo Monza.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Raimondi
authors.affiliation: Direttore Sanitario di Presidio, AO San Gerardo Monza.
authors.forename: Laura
authors.initials: L
authors.lastname: Radice
authors.affiliation: Professore associato in Scienze infermieristiche, Facoltà di Medicina e Chirurgia, Università degli Studi di Milano-Bicocca. email:
authors.forename: Stefania
authors.initials: S
authors.lastname: Di Mauro
mesh_terms: D000368:Aged; D002908:Chronic Disease / Q000451:nursing*; D006699:Home Care Services / Q000592:standards; D006801:Humans; D007558:Italy; D007902:Length of Stay; D008017:Life Expectancy; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge / Q000592:standards*; D011320:Primary Health Care / Q000592:standards; D019145:Rehabilitation Nursing / Q000592:standards; D013997:Time Factors