Elements of progressive patient care in the Yale Health Plan HMO

The results of a study of the use of intermediate care beds in the intermediate care facility (ICF) of the Yale Health Plan, a prepaid group practice plan for students and an enrolled non-student population, indicate that the ICF may be a possible model for other health maintenance organizations. The ICF, with 30 beds in active use, is located in the Yale health center. Approximately one-third of the ICF patients would have been admitted to the affiliated short-term general hospital if the ICF did not exist. The plan's medical staff also has the option of transferring patients between the affiliated hospital and the ICF, depending on which institution is most appropriate for the patient's needs. A comparison of the levels of care provided in the ICF with those presented in selected articles from the progressive patient care literature revealed that the ICF is not only providing intermediate care but several other classic elements of progressive patient care -self care, continuing care, minimal care, and partial care.