Golden Adam G, Ortiz Judith, Wan Thomas T H
Department of Clinical Sciences, University of Central Florida, College of Medicine, Orlando, FL 32803, USA.
Care Manag J. 2013;14(2):78-83. doi: 10.1891/1521-0987.14.2.78.
Potentially avoidable hospitalizations are associated with high costs and an increased risk for iatrogenic conditions in older adult patients. Although care managers may be aware of the common potential pitfalls that may arise in the transfer of patients to and from the hospital defining best practice models has been difficult. Many current models of geriatric care have had little or no impact on lowering the rates of hospitalizations and rehospitalizations when formally studied. Health care reform legislation mandates initiatives involving new models of coordinated or guided care such as the medical home model and the accountable care organization. These new models too will face significant challenges in their attempt to provide the financial incentives and systematic changes needed to successfully address transitional care in older adults.
在老年患者中，潜在可避免的住院与高成本以及医源性疾病风险增加相关。尽管护理管理者可能意识到患者出入院转诊过程中可能出现的常见潜在问题，但确定最佳实践模式一直很困难。许多当前的老年护理模式在正式研究时，对降低住院率和再住院率几乎没有影响。医疗改革立法要求开展涉及新型协调或指导护理模式的举措，如家庭医疗模式和 accountable care organization（可问责医疗组织）。这些新模式在试图提供成功解决老年人过渡护理所需的经济激励措施和系统性变革时，也将面临重大挑战。
