The role of the hospital in the care of the ambulatory chronically ill and disabled patient after discharge.

Abstract

The discharging hospital and more particularly the rehabilitation out-patient clinic emerged as the central source of continuing basic medical care for most patients, rather than agencies outside the hospital or the general medical clinic. A continuing and extensive role in relation to resolving medical and social ''crises'' threatening continued residence in the community of many patients was evidenced by the in-patient service, particularly at the chronic disease hospital site. Crucial to the mobilization and achievement of care and services following discharge is the active and aggressive prodding of hospitals and agencies by the patient or his family.