Hospital Admissions

Hospital Admission

In addition to offering NEUROCARE services to Patients already admitted to care facilities by other Doctors (referred to as the NEUROCARE Hospital Liaison Service), NEUROCARE often admit Patients primarily for tests and treatment after assessment at NEUROCARE Clinics or other venues.

As such NEUROCARE Patients benefit from admission to conventional Medical Hospitals, sub-acute Rehabilitation Hospitals, Mental Health Hospitals which we refer to as Therapy Hospitals, Addiction Centers, selected Frail Care facilities, and in some instances tailor-made Private Facilities.

In all instances our Patients enjoy the advantage of NEUROCARE coordinated care either directly, or NEUROCARE monitoring when a third party is used.

We assure that in all instances the most appropriate Care Facility is chosen for each individual Patient chosen on a basis of clinical need (see below).

Hospitalization often implies additional funding benefit for tests or treatment. However, we encourage all Patients to establish potential co-payments etc with Medical Insurance Companies prior to hospitalization.

A bit of technical detail...

Worldwide Patients are categorized diagnostically by using one of two WHO recognized International Diagnostic Systems. The entire healthcare system depends on applying either the ICD (International Classification of Diseases), or the DSM (Diagnostic and Statistical Manual), the latter being more prominently considered by South African authorities.

Patient Medical Aid Benefits and Healthcare Rights are critically determined by the individual’s DSM diagnostic formulation. Although strictly complying of Axis 1 to 5, the most relevant aspects of the DSM are:

Axis 3: Diagnosed physical illness e.g. Diabetes, Epilepsy, Parkinson’s etc.

Axis 1: Diagnosed mental illness e.g. Schizophrenia, Depression etc.

Each illness also has a corresponding ICD Code. Conditions on Axis 3 have numerous codes starting with letters A-Z, and conditions on Axis 1 have codes starting with F. Additionally Prescribed Minimum Benefit (PMB) conditions each carry a different PMB Code.

All Patients theoretically fall into one of three subtypes:

Those suffering only a physical condition (Axis 3 only),
Those suffering only a mental condition (Axis 1 only), and
Those suffering “mental health” problems secondary to their physical condition (Axis 3 and 1).

Physicians and other medical- and surgical Specialists treat those Patients suffering only an Axis 3 condition, Psychiatrists treat mostly those Patients suffering only an Axis 1 condition, and Liaison Neuropsychiatrists focus on those Patients where prominent Axis 3 and 1 conditions are present simultaneously (or caused by one another).

“Liaison Neuropsychiatrists” concerns themselves therefore with “physical illnesses affecting brain or mind”.

Physical illnesses presenting regularly with Neuropsychiatric complications include Stroke, Dementia, Epilepsy, Parkinson’s disease, HIV, Traumatic Brain Injury, Cancer and many more.

Because of the prevalence and magnitude of many of these conditions, Neuropsychiatric service delivery has become perhaps the most focused topic in healthcare in countries with advanced healthcare systems e.g. the USA, UK, Canada etc.

Sadly South Africa lags behind considerably in both State and Private Neuropsychiatric service delivery, which is ironic considering our rates of HIV infection, Traumatic Brain Injury (from accidents and violence), and aging population (Stroke, Dementia and Parkinson’s Patients).

In South Africa one may lead a perfectly healthy life (never being diagnosed with a “mental condition”), then develop a very clear physical illness such as Parkinson’s illness or Epilepsy, which then cause you to develop a complication such as hallucinations, followed by you promptly being labeled “Psychiatric”.

Specialists agree that Patients with only Axis 1 diagnoses suffering the so-called “conventional” mental illnesses, is best treated in tailor-made Therapeutic hospitals.

However, forcing the admission of Neuropsychiatric patients (with both Axis 3 and 1 conditions) to Therapeutic hospitals is grossly unethical as such Patient’s physical health treatment is almost always seriously jeopardized at such institutions. Thankfully a growing understanding amongst some will continue to drive further Neuropsychiatric service development.

Interesting the legislation and medico-legal frame (such as the Patient Charter, PMB provisions, Human Rights Act etc.) is in place to facilitate future optimal care delivery.

In line with international trends and standards, Healthcare Insurers (Medical Aids), Institutions (State- and Private Hospitals), and Service Providers (Doctors) in South Africa will have to become attuned to Patients executing their rights to be treated in appropriate settings for their specific DSM Formulated Diagnosis.

Comments are welcome and invited by email: jan@neurocare.co.za