Role and position of day hospital within Serbian health care system

Introduction: In accordance with the Regulation on the Plan of Health Care Facilites Network ('RS Official Gazette' No. 42/06), the day hospital, as a special unity of the hospital policlinic service, has been organized for carrying out diagnostic, therapeutic and rehabilitation services for outpatients in following areas: nephrology (hemodialysis and peritoneal dialysis) and other internal branches of medicine, surgery and psychiatry. The treatment of patients in a day hospital is always shorter than 24 hours, and may require several arrivals (days of treatment). The advantages of such type of treatment are numerous. Favorable psychological components for a speedier recovery, decreased risk of intrahospital infections, saving on hospital resources. Aim: To analyze capacities and functioning of day hospitals in Belgrade (not including day hospitals for hemodialysis, which are specially organized and financed). Data from 1996 - 2006 Hospital Plan Reports and target research performed in 2003 and 2004 have been used as a source. Results: In Belgrade, day hospitals function in 23 hospitals with 1086 beds and 63000 of treated persons per year. During last ten years, day hospital capacities have been increased for 156 beds (17%), and the number of treated persons for 5643 (10%). Almost one half of the total bed capacity is in psychiatric day hospitals (49%), and 24% of the capacities serve for rehabilitation. Greatest capacity usage is in day hospitals for chemotherapy and the smallest in these for rehabilitation. There are numerous problems in organizing and functioning of day hospitals since space capacities, necessary equipment, medical documentation, 'basket of services' provided in a day hospital, financing of provided services have not been defined by the current regulatin. Also, surgery capacities of the day hospitals are insufficiently developed and citizens have not been informed on possibilities of day hospital for treatment and rehabilitation. Conclusion: Although there are numerous problems and insufficient legal regulations in this area in our country, hospitals develop day hospitals on their own initiative as a form of treatment with significant advantages in regard to hospitalization.