Abrashkin Karen A, Cho Hyung J, Torgalkar Sohita, Markoff Brian
Mount Sinai School of Medicine, New York, NY, USA.
Mt Sinai J Med. 2012 Sep-Oct;79(5):535-44. doi: 10.1002/msj.21332.
As the cost of care rises and fragmentation of health care increases, care transitions have become critical parts of the health care system. Physicians and other inpatient providers have the responsibility to communicate to subsequent providers, but such communication occurs far less than is optimal. Timely discharge summaries for the next-level provider, postdischarge phone calls to patients, and postdischarge follow-up appointments with primary-care physicians or inpatient providers may improve postdischarge health care utilization. Pharmacists may also reduce medication errors, adverse medication events, and even readmissions. The most promising data, however, come from studies of multidisciplinary approaches, some of which have shown large reductions in postdischarge utilization and costs. More study is needed to pinpoint the most cost-effective and efficient strategies to improve transitions from the inpatient setting to other settings.
随着医疗成本的上升以及医疗保健碎片化程度的增加，护理转接已成为医疗保健系统的关键组成部分。医生和其他住院医疗服务提供者有责任与后续的医疗服务提供者进行沟通，但这种沟通的发生频率远低于最佳水平。为下一级医疗服务提供者及时提供出院小结、出院后给患者打电话以及与初级保健医生或住院医疗服务提供者进行出院后随访预约，可能会改善出院后的医疗保健利用情况。药剂师也可以减少用药错误、药物不良事件，甚至再入院情况。然而，最有前景的数据来自多学科方法的研究，其中一些研究表明出院后利用率和成本大幅降低。需要更多的研究来确定最具成本效益和效率的策略，以改善从住院环境到其他环境的转接。
