Conners Gregory P, Kressly Susan J, Perrin James M, Richerson Julia E, Sankrithi Usha M
Pediatrics. 2017 May;139(5). doi: 10.1542/peds.2017-0629.
The American Academy of Pediatrics (AAP) affirms that the optimal location for children to receive care for acute, nonemergency health concerns is the medical home. The medical home is characterized by the AAP as a care model that "must be accessible, family centered, continuous, comprehensive, coordinated, compassionate, and culturally effective." However, some children and families use acute care services outside the medical home because there is a perceived or real benefit related to accessibility, convenience, or cost of care. Examples of such acute care entities include urgent care facilities, retail-based clinics, and commercial telemedicine services. Children deserve high-quality, appropriate, and safe acute care services wherever they access the health care system, with timely and complete communication with the medical home, to ensure coordinated and continuous care. Treatment of children under established, new, and evolving practice arrangements in acute care entities should adhere to the core principles of continuity of care and communication, best practices within a defined scope of services, pediatric-trained staff, safe transitions of care, and continuous improvement. In support of the medical home, the AAP urges stakeholders, including payers, to avoid any incentives (eg, reduced copays) that encourage visits to external entities for acute issues as a preference over the medical home.
美国儿科学会（AAP）确认，儿童接受急性非紧急健康问题护理的最佳场所是医疗之家。AAP将医疗之家描述为一种护理模式，即“必须是可及的、以家庭为中心的、持续的、全面的、协调的、有同情心的且具有文化有效性的”。然而，一些儿童及其家庭会在医疗之家以外使用急性护理服务，因为他们认为在可及性、便利性或护理成本方面存在实际或感知到的益处。此类急性护理机构的例子包括紧急护理设施、零售诊所和商业远程医疗服务。无论儿童在何处获取医疗保健系统，他们都应获得高质量、恰当且安全的急性护理服务，并与医疗之家进行及时且完整的沟通，以确保协调和持续的护理。在急性护理机构中，按照既定、新出现及不断演变的实践安排对儿童进行治疗时，应遵循护理连续性和沟通的核心原则、既定服务范围内的最佳实践、经过儿科培训的工作人员、安全的护理过渡以及持续改进。为支持医疗之家，AAP敦促包括支付方在内的利益相关者避免任何鼓励因急性问题而优先前往外部机构而非医疗之家就诊的激励措施（例如降低自付费用）。
