Information on patient admission and discharge

INFORMATION REGARDING PATIENT ADMISSION

Hospital medical services are provided to insured patients based on the following documents:

identity document;
admission ticket signed by the specialist doctor in the outpatient clinic or the family doctor (within the validity period required by CNAS under the framework contract);
health card / replacement certificate issued by the County Health Insurance House (CJAS);
proof of insured status: certificate from the workplace confirming payment of the health insurance contribution, certificate issued by the CJAS of domicile, or pension slip. Insured status will be verified at the Admission/Discharge Office via www.cnas.ro;
if the patient is NOT found in the database or CANNOT present proof of insured status, they will sign a PAYMENT COMMITMENT — a document by which the patient undertakes to present proof of insured status in due time or pay the hospitalization costs;
if an insured or uninsured patient requests a medical intervention not included in the list of hospital services reimbursed by the social health insurance system, the patient will sign a PAYMENT COMMITMENT for the requested services at their own expense.

Before admission, the patient must perform an RT-PCR or Antigen Covid-19 test; the cost is borne by the patient.

The admission of patients to healthcare facilities is carried out based on the following criteria:

Progressive evolution with worsening of symptoms and/or laboratory values and/or decline in functional status (ECOG status 3–4).
Severe or terminal stage at initial diagnosis.
Hypoanabolic syndrome and critical nutritional impairment with weight loss of 5% or more in the last 3 months during a progressive disease and/or irreversible dysphagia.
Presence of severe comorbidities leading to a life expectancy of 12 months or less.
Acute/chronic irreducible pain syndrome (VAS = 6–7).

Hospital medical services are provided to insured patients based on the following documents:

identity document;
admission ticket (CAS model) with reference “Palliative Care”;
health card / replacement certificate issued by the County Health Insurance House (CJAS);
proof of insured status (pension slip, certificate of insured/co‑insured);
patient medical file (medical history, prescribed medications, tests/investigations performed, hospital discharge notes);
other documents, as applicable.

Discharge from the ward is made on the recommendation of the attending physician according to the patient’s health status evolution.

Scheduling and communication of discharge will be made at least 12 hours before discharge.
For patients requiring accompaniment, family members/caregivers are notified at least 48 hours before discharge.

discharge form / medical letter in at least 2 copies: one copy is presented to the family doctor and/or the outpatient specialist for registration, another for continuity of care services for cases requiring continuous monitoring immediately after discharge, and for issuing any prescriptions or extending sick leaves;
a copy of the medical expense statement for the hospitalization period;
a copy of the histopathology result (if not included in the discharge summary/medical letter) for patients from whom tissue was taken for biopsy. If the histopathology result is not yet available at discharge, the patient will be informed of the date when it can be collected;
medical certificate, if requested for submission to the employer (according to the specific procedure for completion and issuance), as well as any necessary specifications for its extension;
free, compensated, or simple medical prescription, as applicable;
referral to other specialists or for various paraclinical investigations (as applicable);
medical report for expertise services (as applicable).

the patient diagnosed with a chronic condition is registered in the admissions register;
a discharge form is issued with mention of outpatient follow-up of the chronic condition;
a medical letter is issued to the family doctor stating the chronic condition and the treatment plan;
the need to register the patient in the chronic disease register and monitor them will be noted;
the obligation to present to the family doctor with the documents issued by the hospital will be indicated.

the condition they suffer from / possible complications;
the treatment plan;
the obligation to follow treatment instructions and the hygienic-dietary regimen;
urgent presentation to the doctor at any sign of worsening.

frequency of check-ups at the specialty outpatient clinic;
frequency of presentation for admission and re-evaluation of the condition, with the analysis package performed to adjust the therapeutic plan;
observance of the therapeutic and lifestyle plan.