Sub-acute care: A fundamental step into patient recovery

Acute vs. sub-acute care

Acute care and sub-acute care are different medical terms used to describe either the duration, and or severity of an episode or the progress in continuum of care from one phase to another during the health journey.

Acute care is often a shorter-term, often more severe and more expensive care episode. It includes the costs of emergency room visits, hospitalizations, and surgeries. Sub-acute care is when the treatment doesn’t warrant acute care any longer or describes the period of time during which patients transition from acute care to home recovery or rehabilitation. Sub-acute care services may include physical therapy, occupational therapy or speech therapy – all of which help increase recoveries for those suffering from common ailments like heart disease, stroke or recovering from surgery.

Sub-acute and in-home care are often not considered “as important as acute care” but may be as much as two-thirds of the whole episode of care, which are mostly neglected by patients. This could lead to frequent readmissions and sometimes even worse outcomes due to not caring properly for rehabilitation or recovery.

Sub-acute: an integral step in the continuum of care

Each patient’s needs differ after hospitalisation and often these needs can be better addressed at a facility which specialises in rehabilitation or taking care of individuals after the often, “traumatic”, event of a hospital stay (sudden disruption in “normal life”).   

This is often determined by what was the predisposing condition or event as a fall and fracture or underlying chronic diseases such as diabetes mellitus, stroke or chronic lung disease.

This very important continuum of patient care, which, if ignored, will lead to prolonged recovery, serious complications and a significant increase in healthcare costs. It is imperative that the recovery process is taken as seriously as the actual acute health event in order to circumvent the chance of ending up in a worse health state than before an operation or treatment in an acute facility. The aim being, to optimise the health status of the patient to the same, or better than, before the event which required admission.

This continuum of care usually starts at the acute care facility, which offers the intensive and comprehensive care a patient requires as part of treatment. After a patient is stabilised and is well on the road to recovery, further admission to an acute hospital is often unnecessary and would only lead to a more costly hospital bill.

When a patient still requires some medical attention to ensure full recovery, the next step in the continuum of care, before being discharged home to care for themselves, or assisted home care, will be to receive sub-acute or rehabilitative care to ensure mobilisation and the ability to cope at home. The latter includes ensuring the coping skills of the other family members are also addressed to ensure a holistic recovery process.

For this reason, a very exciting development in healthcare has been the introduction of sub-acute facilities.

What to expect from sub-acute care

After discharge from an acute facility, comprehensive care at home is normally not readily available and a reality for the majority of patients, whilst funding of such care may be problematic.    

For this reason, a very exciting development in healthcare has been the introduction of sub-acute facilities.

Sub-acute facilities offer a wide range of services which allows for the possibility of a patient’s treatment plan being customised to address specific concerns – so-called “patient-centric care”. This treatment plan is created in line with requests sent by the specialist practitioners who attend to a patient while in the acute hospital.

A multidisciplinary approach is followed which can include services such as specialist or general practitioner visits, nursing assistance, physiotherapy, occupational therapy, psychology, social worker assistance, and many others. In this setting great value has been placed on patient education and involving family members in the rehabilitation process to ensure a fluid transfer from inpatient care to being placed in society again.

Benefits of sub-acute care

It has been found that using these facilities has filled a gap in the care of patients. Re-admission rates, complications, undue mental health issues, increased healthcare costs and financial burden on patients and their families, as well as prolonged recovery have all been lowered through the appropriate use of sub-acute and rehabilitation facilities.

In South Africa, the benefit of these stepdown and rehabilitation facilities is being recognised and awareness is being created to ensures that the use of these valuable additions to the healthcare system is optimised for the benefit of the patient.

Medical Schemes in most cases cover most of a patient’s stay for sub-acute care, which can significantly lighten the burden during these challenging times, not to mention the positive impact such a stay can have on a patient – both physically and mentally. Here is an example of a patient testimonial after their stay at Senso Health in our Sea Point facility:

“It was the first time I had ever been in a step-down facility, and I never realised before just how important a role it was going to play in my recovery. All the staff were very caring and that made a huge difference to one’s return to health. I thank you all, for the time I spent with you.”

-Mr. Devine, August 2022

Treating physicians and specialists build a relationship with the staff at the sub-acute facility, and even have input in the patients’ tailored care plan during their stay, allowing the continuum of care to be focused and effective.

In conclusion, sub-acute care plays an integral part in the continuum of care and has become a recognised and established practice within South Africa to enhance recovery and reduce readmissions after a health event.