ABSTRACT
In this essay, the authors provide a definition for those medical care facilities representing a consolidated alternative to traditional hospitalization. These facilities can be basically ascribed to the following patterns: day case surgery; day-hospital activity; home-care. Day case surgery is a complex and, in most cases, interdisciplinary procedure; this type of activity necessitates a pre-hospitalization period and often also a "protected discharge" or even a home-care service. Some specific criteria regarding day surgery activity have been defined as follows: the main criteria have a clinical nature, but they interact with others belonging to a social and structural-organizational order. The Royal College of Surgeons of United Kingdom has officially recognized in 1985 this medical care typology as one of the constituents of surgical care, and has evaluated that at least 1/3 of the overall operations could be carried out as day care surgery. In the United States, besides hospital and ambulatory surgery activity, a new pattern known as "free-standing center" has been promoted; in 1993, 35% of the operations is expected to be carried out in day case surgery centers. As far as Italy is concerned, in 1988 only day-hospital practice has been adequately recognized as an alternative medical care facility to traditional hospitalization. The Emilia Romagna region, in order to increase day case surgery activity, has issued in 1991 a list of 53 DRGs, in which day bed units treatment was possible. Up to now, however, only a small part of these diseases is treated on a day case surgery basis.
Subject(s)
Ambulatory Care Facilities/organization & administration , Ambulatory Surgical Procedures , Models, Organizational , Day Care, Medical/organization & administration , Diagnosis-Related Groups/organization & administration , Italy , United Kingdom , United StatesABSTRACT
The paper reports two cases of transitory hyperphosphatasemia in two siblings of 13 and 29 months without modifications of the liver, kidney or bones. Laboratory data are given for hepatic and renal function and for the calcium/phosphorus metabolism. The paper underlines the observation of rotavirus and the consequent clinical symptoms in the two subjects. The hypothesised etiopathogenesis of transitory idiopathic hyperphosphatasemia is referred to a viral mechanism, and to rotavirus in particular.
