Hospital or Home Treatment. What Is It For? - Dr. Zsolt Zátrok's blog

First you need to understand that healthcare is provided at multiple levels. Each level has different tasks and different responsibilities.

What are the roles of a clinic and a hospital ward?

A clinic is a healthcare facility run by a medical university. It is essentially the same as a hospital, but a clinic has the highest level of equipment and the most highly trained specialists. In other words, in theory a clinic can provide the very best care. A county hospital, and then smaller city hospitals, have more limited equipment and scopes of care compared to a clinic.

Not every case is so severe that it requires care at a clinic; not everyone needs to be sent to a clinic. Most conditions can be excellently managed and resolved at the level of the city hospital.

The fundamental aim of hospital care is to recognize (diagnose) acute and potentially life-threatening health problems, stabilize the patient's condition, and carry out the steps of recovery that require the highest level of expertise and equipment. In this context, the following may occur:

• Diagnostics: Hospitals have the necessary tools and experts to accurately diagnose diseases and health conditions.
• Acute treatment: Treatment of severe, life-threatening conditions that may require urgent medical intervention.
• Surgical interventions: Many surgical procedures, including emergency and planned operations, take place in a hospital setting.
• Subacute care and nursing: After a life-threatening issue has been resolved or after surgery, patients often need intensive care, continuous monitoring, and precise medication management. They receive this in the subacute care units.
• Information and counseling: Patients and their family members are informed about the illness, the treatment, and the role of home rehabilitation.

Why were you sent home?

There can be many reasons why you were discharged from hospital, including improvement in your condition, the feasibility of continuing care at home, and the current capacity of the healthcare system. It is important to note that being discharged rarely means you are fully recovered. Rather, it usually means: the doctors have judged that the further recovery no longer requires the equipment and professional level of the clinic/hospital and that treatment can safely continue in your home.

If the hospital discharged you, it means the immediate threat to your life has passed, but there may still be tasks to restore you as fully as possible to your pre-illness state.

The out-of-hospital care system helps with this: your general practitioner, regional specialist clinics, and rehabilitation institutions.

What is rehabilitation? Why is it necessary?

Rehabilitation is closely linked to hospital care and is the next step toward recovery—especially in cases where the patient requires a longer healing process. The goals of rehabilitation are:

• Restoration of functional abilities: Optimizing physical, mental, and/or cognitive abilities.
• Increasing independence: Helping the patient regain autonomy and a quality lifestyle as soon as possible.
• Management of chronic conditions: Assisting with long-term or permanent health problems.
• Health counseling: Supporting lifestyle changes, proper nutrition, and home exercises.

Rehabilitation can be inpatient (acute rehabilitation in hospital) or outpatient (at home or in a rehabilitation center), depending on the level of support the patient needs. As part of the complete recovery process, coordinated cooperation between hospital care and rehabilitation is crucial for optimal patient recovery.

What is the role of rehabilitation professionals and what is yours?

During rehabilitation, many tasks require the presence of rehabilitation professionals such as a physiotherapist, movement therapist, medical fitness trainer, speech therapist, or rehabilitation physician. These specialists help the patient in areas where expert knowledge and practical guidance are needed. Such tasks may include:

• Personalized physiotherapy: The therapist helps you learn the exercises needed to resolve musculoskeletal problems and to regain strength and mobility. Attending 1–2 physiotherapy sessions is only the learning phase! You cannot improve with only that much. The physiotherapist will meet you 5–10 times so you thoroughly learn the exercises that you must perform at home several times a day for weeks or months to achieve improvement. No matter how much the physiotherapist exercises with you, you will not improve unless you do the exercises yourself! That means you must perform the exercises as much as possible. The more often you do them, the better results you can expect.
• Speech therapy: The speech therapist works with patients who have speech and language disorders as well as swallowing problems.
• Mental health support: A psychologist can help treat trauma, depression, or adjustment disorders.
• Specialized medical advice: The rehabilitation physician supervises the entire rehabilitation process, including specialized treatments and pharmacotherapy.

The patient can do the most for restoring their health by, for example:

• Exercises and self-care: Regularly performing the exercises recommended by the professionals at home.
• Healthy lifestyle: Healthy nutrition, adequate fluid intake, sufficient sleep, and stress management.
• Goal setting and motivation: Setting realistic goals and maintaining commitment to recovery.
• Environmental modifications: Adapting the living environment to the patient's current abilities, for example by installing safety grab bars.
• Positive attitude and supportive community: Positive thinking and accepting support from family, friends, or support groups.

If the patient understands that they must actively participate in the rehabilitation process for their own good, this increases the chances of recovery and improves quality of life.

How much is enough?

Rehabilitation professionals are overloaded, so their time is divided among many patients.

A single outpatient “session” is usually 10–15 minutes. That is certainly not enough to restore your mobility.

• Talk to your treating physician: Ask that, if possible, further therapy be prescribed.
• Do exercises at home: The physiotherapist will teach you exercises that are important for solving your problem. Learn them and practice them several times a day. More is better and can speed up your recovery.
• Regularity and commitment: Be consistent in doing the home exercises. Regular movement and perseverance are key to improvement.
• Group therapy: Group therapies can help improve and maintain your motivation.
• Information: Learn about your illness and the methods that can lead to improvement.
• Maintain a healthy lifestyle: Proper exercise, nutrition, sufficient rest, and stress management all contribute to recovery.
• Feedback and evaluation: Regularly share your experiences with your therapist so they can modify the treatment plan if necessary.

Remember: recovery is often a slow process, and every step you take toward improvement is important. With patience and commitment, and with the right support, your condition can gradually improve.

What helps recovery?

Recovery is a complex process that includes the treatment and the biological response your body gives to that treatment. Both play important roles in healing.

The role of treatment:

• Targeted intervention: Treatments such as medications, surgical procedures, or physiotherapy aim specifically at addressing the cause of the disease or injury.
• Symptom relief: They help reduce pain and inflammation and improve functional abilities.
• Prevention and protection: Some treatments, like vaccinations, are preventive and help avoid the development of health problems.

The body's biological responses:

• Self-healing ability: The body has a natural capacity for self-repair. Treatments mainly support or accelerate this process.
• Immune response and inflammation control: Treatments stimulate the immune system to fight infections and inflammation.
• Regeneration: Physiotherapy aids the regeneration of damaged tissues and the restoration of mobility.

Thus, recovery is a two-way street: the treatment itself and the body's biological responses work together to overcome the disease and improve health.

In this process, the patient's active participation is also important—for example by following treatment instructions, maintaining a healthy lifestyle, and taking care of mental well-being. All of these factors together contribute to full recovery.

What is the right treatment strategy?

Choosing the most appropriate treatment strategy depends on the specific health condition, the severity of the disease, the patient's individual needs, and the available treatment options. There are two main approaches: using a single treatment method and multimodal (multiple methods together) treatment.

Single treatment method

It is sensible to apply this only when the disease is specific and well-defined and there is one proven effective treatment. For example, in certain infections a particular antibiotic may be the best choice.

Multimodal treatment

• Combines several different therapeutic approaches to address the disease from multiple angles.
• Can be applied in more complex, chronic, or multifactorial conditions, such as chronic pain, cancer, or mental health problems.
• Its advantage is that different therapies can complement each other, improve the patient's condition, and reduce side effects.

Multimodal treatment can be especially useful where the disease is based on multiple factors or where treatment must address not just physical but also mental and emotional aspects.

It is always important, however, that treatment decisions be tailored to the individual needs of each patient.