[The day care unit--a patient and personnel oriented and cost effective patient management?]

Based on the increasing number of chronically ill patients with restricted life expectancy it was necessary to reorganize the health care system. Aim of the study was to evaluate the benefits for patients and health care workers and the costs of day hospital care. In March 1991 a day clinic with 20 beds for HIV-antibody negative and HIV-infected patients was established. The number of patients treated increased from 122 patients in April 1991 to 487 patients in March 1993. During a 6 1/2-month period in 1994 2745 patients--33% were HIV-infected - were treated and diagnosed on this ward. The mean duration of hospital stay was 1.8 days. From January 1994 till 19th July 1994 200 diagnostic invasive procedures were performed, 150/200 were bronchoscopies. During the same period 158 non invasive diagnostic procedures were done. 436 cycles of chemotherapy were applicated and 277 patients were treated with blood products. 55/2745 patients (2%) had to be admitted to the ward because of worsening of the clinical condition. Based on the increasing number of patients who preferred the day clinic to the ward, it was an optimal sort of taking care for patients. Based on the results of questionnaires answered by nurses, working at the day clinic is beneficial for health care workers. Since the mean duration of hospital stay is reduced to 1.8 days the day clinic is cost-effective.