Stoicea Nicoleta, Magal Samarchitha, Kim January K, Bai Michael, Rogers Barbara, Bergese Sergio Daniel
Department of Anesthesiology, Wexner Medical Center, The Ohio State University, Columbus, OH, United States.
College of Medicine and Life Sciences, University of Toledo, Toledo, OH, United States.
Front Med (Lausanne). 2018 Dec 7;5:342. doi: 10.3389/fmed.2018.00342. eCollection 2018.
As the geriatric population in the United States continues to age, there will be an increased demand for total hip and total knee arthroplasties (THAs and TKAs). Older patients tend to have more comorbidities and poorer health, and will require post-acute care (PAC) following discharge. The most utilized PAC facilities following THA and TKA are skilled nursing facilities (SNFs), in-patient rehabilitation facilities (IRFs), and home with home health care (HHC). Coordination of care between hospitals and PACs, including the complete transfer of patient information, continues to be a challenge which impacts the quality of care provided by the PACs. The increased demand of hospital resources and PACs by the geriatric population necessitates an improvement in this transition of care process. This review aims to examine the transition of care process currently utilized in the United States for orthopedic surgery patients, and discuss methods for improvement. Employing these approaches will play a key role in improving patient outcomes, decreasing preventable hospital readmissions, and reducing mortality following THA and TKA. The extensive nature of this topic and the ramification of different types of healthcare systems in different countries were the determinant factors limiting our work.
随着美国老年人口持续老龄化，全髋关节置换术和全膝关节置换术（THA和TKA）的需求将会增加。老年患者往往合并症更多、健康状况更差，出院后需要接受急性后期护理（PAC）。THA和TKA后最常用的PAC机构是专业护理机构（SNF）、住院康复机构（IRF）以及接受居家医疗护理（HHC）的家庭。医院与PAC之间的护理协调，包括患者信息的完整交接，仍然是一项挑战，这会影响PAC所提供的护理质量。老年人口对医院资源和PAC的需求增加，因此有必要改进这一护理过渡过程。本综述旨在研究美国目前用于骨科手术患者的护理过渡过程，并探讨改进方法。采用这些方法将在改善患者预后、减少可预防的医院再入院率以及降低THA和TKA后的死亡率方面发挥关键作用。本主题的广泛性以及不同国家不同类型医疗保健系统的影响是限制我们工作的决定性因素。
