Criteria and prioritisation of admission through the Catalan Public Health System (CatSalut)
An adult or child patient affected by a severe neurological disability.
They should meet the appropriate conditions to benefit from the intensive and short-term treatment provided by the Institut Guttmann (generally under 70 years of age and, especially, under 60 in the case of stroke in accordance with the provisions of the “Catalan Master Plan for Cerebrovascular Disease”).
They should have a state of consciousness and cognitive response capable of actively participating in the rehabilitation process. Patients in a minimally responsive state will be assessed. An unresponsive waking state has no entry criteria.
They should be hemodynamically stable and the associated injuries and/or comorbidity should not prevent or advise against following the intensive treatment of our therapeutic plans.
They should be in the critical or acute phase (a maximum of three months after the injury). This will be assessed in subacute cases, according to the place of origin so as not to interfere in a rehabilitation process that is already being carried out.
The highly specialised service that the Institut Guttmann represents within the portfolio of public healthcare services should be the most suitable for the patient based on the prognosis for recovery and subsequent social reintegration.
Prognosis for recovery: This essentially depends on the aetiology of the injury, the severity, the time since the injury and the patient's age.
Prognosis of social reintegration: In addition to clinical factors, this type of intensive and specialised treatment only achieves its full potential when the patient has a family that is willing, just like the patient, to “start a new life”. When this is not the case, an adequate social healthcare resource, or a commitment to accept this centre prior to admission to our hospital, is the most appropriate, efficient and fairest option from a social point of view.
Patients who have suffered an injury to the brain, spinal cord or peripheral nervous system of any aetiology that generates a severe impairment.
Patients who come directly from acute hospitals (ICU or neurology services, neurosurgery...), and the earlier the better for the best end result.
Patients with a sufficient level of cognitive response to participate in the therapeutic programme.
Patients who have no severe comorbidities (severe heart failure, respiratory isolation, chemotherapy treatments, severe COPD...) that interfere with the rehabilitation programme, both physically and cognitively.
Patients under 70 years of age in any aetiology except in the case of stroke in which the limit has been established at 60 years of age by the team of rehabilitation experts of the Catalan Master Plan for Cerebrovascular Disease.