Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA.
J Am Board Fam Med. 2013 May-Jun;26(3):239-40. doi: 10.3122/jabfm.2013.03.130094.
By providing enhanced primary care and social services to patients with high utilization of expensive emergency and hospital care, there is evidence that their health can improve and their costs can be lowered. This type of "hot-spotting" improves the care of individual patients. It may be that these patients live in communities with disintegrated social determinants of health, little community support, and poor access to primary care. These "cold spots" in the community may be amenable to interventions targeted at linking primary care and public health at broader community and population levels. Building local communities of solution that address the individual and population may help decrease these cold spots, thereby eliminating the hot spots as well.
通过为高频率使用昂贵急诊和住院服务的患者提供强化初级保健和社会服务,可以改善他们的健康状况并降低成本。这种“热点发现”(hot-spotting)可以改善个体患者的护理。这些患者可能居住在社会健康决定因素被破坏、社区支持较少且获得初级保健机会有限的社区中。这些社区中的“冷点”(cold spots)可能可以通过干预措施得到改善,这些干预措施旨在将初级保健和公共卫生联系起来,以实现更广泛的社区和人群层面。建立解决个人和人群问题的本地社区解决方案可能有助于减少这些冷点,从而消除热点。