section-37ac312
Dismissal conditions
Discharge from the hospital can be done
Discharged at the end of the treatment or at the end of the acute phase of the disease.
At the end of the treatment or when the acute phase of the disease is over, the Medical Letter is completed upon discharge, in 2 copies, one will be attached to the FOCG, and the other will be given to the patient to be sent to the family doctor. When leaving the hospital, the patient is given, if necessary, treatment, diet, life and work instructions.
The doctors who carry out their activity in the hospital have the obligation to send to the family doctor or the specialist doctor from the ambulatory clinic, as the case may be, a MEDICAL LETTER DISCHARGE TICKET with the obligation that it explicitly contain all the elements provided for in the medical letter, the evaluation the state of health of the insured at the time of discharge and the indications for treatment and therapeutic supervision for the next period (determined according to the diagnosis), information that must also be found in the general clinical observation sheet at the epicrisis.
At the request of the patient being discharged, the MEDICAL CERTIFICATE is completed and handed over.
Depending on the evolution of the hospitalized patient, the attending physician will determine the discharge date.
After the discharge date has been established, it will be communicated to the patient one day before the discharge or, at the latest, in the morning of the day of discharge.
The attending physician completes the discharge status, codes the discharge diagnoses, notes the type of discharge.
The doctors who carry out their activity in the hospital have the obligation to send to the family doctor or the specialized doctor from the outpatient clinic, as the case may be, a MEDICAL LETTER DISCHARGE TICKET with the obligation that it explicitly contain all the elements provided in the medical letter, the evaluation the state of health of the insured at the time of discharge and the indications for treatment and therapeutic supervision for the following period (determined according to diagnosis), information that must also be found in the general clinical observation sheet at the epicrisis.
The recommendations are explained by the attending physician. If necessary, the doctor will inform the patient of the interval until the next check-up in the integrated outpatient clinic.
The treatment will be prescribed on free, compensated or simple prescriptions, depending on the case. Free or compensated prescriptions are issued only if the patient has proven that he is insured and on the hospitalization referral ticket it is specified that the patient has not received a free compensated prescription in the last 30 days.
After handing over the documents, the patient will be taken to the hospital cloakroom and will change into outdoor clothes.
If the patient cannot move alone, he is accompanied until leaving the hospital by a stretcher bearer or a nurse, from where he will be picked up by his family or companions.
The patient's medical file, which is made up of the FOCG and all medical documents created during hospitalization, are archived and kept according to the Archival Nomenclature.
Dismissal on request
The patient can leave the hospital upon request, after having been informed in advance of the possible consequences on his state of health. The attending physician records the patient's request for discharge in the FOCG, and the patient signs that he has requested discharge. Standard forms can be created in which the patient will request discharge. The possibility of leaving the hospital on request does not apply in the case of communicable diseases and in other cases provided by law.
The attending physician:
Sign and initial FOCG
Establishes the discharge diagnosis
Determines the patient's condition upon discharge
Prescribing treatment on free, compensated or simple prescriptions.
Fill out the medical certificate or medical certificate
Explains the treatment and recommendations to the patient
Determine the date of the control consultation
Performs the coding of the diagnosis at discharge and of the secondary diagnoses (complications and comorbidities) for a maximum of 6 conditions, concurrent with the main diagnosis, passing exclusively the complications and comorbidities for which the patient was investigated and treated during the respective episode of the disease; is coded by the attending physician in accordance with the RO.vi.DRG classification, provided for in the Order of the Minister of Health no. 1.0272010, as amended.
Documents released:
Medical letter Hospital discharge ticket.
Medical leave certificate, as the case may be.
Medical certificate - for pupils, students, etc., as the case may be.
Free prescription compensated
Form - Application for discharge on own responsibility, as the case may be.
Statement of expenses at discharge for the medical services received.
The documents are completed according to the completion regulation.
Documents circulate only to the patient upon discharge and to the archive, according to the document circulation schedule.