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Health systems in transition Hungary 153
5.7 Rehabilitation/intermediate care
Rehabilitation is defined in Hungary as all organized activities whose primary
aim is to support the reintegration of temporarily or permanently disabled
people into the community by restoring or preserving their remaining abilities.
A complex intersectoral service, rehabilitation requires the coordinated actions
of health care services, psychological services and the educational, occupational
and social sectors. Medical rehabilitation aims to improve and substitute
for impaired abilities through physiotherapy, sport therapy, speech therapy,
psychological services, occupational therapy and medical devices (including
medical aids and prostheses, as well as training in their use). Some alternative
treatments provided frequently by medicinal spas and sanatoria are also defined
as rehabilitative care, including speleotherapy and treatments with medicinal
waters and mud (1997/20, 1999/13).
Rehabilitation services can be provided in an outpatient, inpatient, home
care or daytime hospital setting by hospitals (using rehabilitation beds, in a
daytime hospital unit, or in hospital outpatient centres), by daytime hospitals (in
a daytime hospital or outpatient setting), by polyclinics (solely in an outpatient
setting) and by home care providers in the patient’s home (1999/1). Although
intermediate care is not recognized as a separate service category, the daytime
hospital is an intermediary type of facility that was first introduced in 1993
(1993/6) and further defined in 2003 (2003/15) to increase service provision
outside the traditional inpatient care setting and thus prevent unnecessary
hospitalization. A provider or department/unit of a provider can be considered
a daytime hospital if it meets the minimum technical and material requirements
of an inpatient care unit for at least 8 hours per day, 5 days a week. Importantly,
the care provided by daytime hospitals is not the same as day care, which is
described in section 5.4.3 (2003/15).
Any of these providers can be multi-specialty (for example, an acute hospital
with a rehabilitation unit or department) or dedicated solely to the provision of
rehabilitation services. In the latter category, three special subgroups should
be distinguished.
First, there are so-called sanatoria, which provide inpatient and outpatient
rehabilitation along with natural/alternative treatments for patients with
conditions of the circulatory, respiratory, endocrine and locomotor systems, and
who have a valid referral from an authorized specialist (1995/6). An annex to the
relevant decree lists six sanatoria, four of which are state hospitals directly run
by the State Secretariat for Healthcare, but omits one special-status sanatorium.