Ng Shu Ee, Chen Matthew Zx, Seetharaman Santhosh Kumar, Merchant Reshma
World Hosp Health Serv. 2016;52(2):27-30.
Frail elderly patients require a longer time to recuperate after hospitalization, and are often discharged home from the hospital with little support despite their needs fpr complex care. They are particularly vulnerable to hazards of hospitalization and fragmented care if not appropriately managed. A geriatrician-led transitional care program called NUH-to-Home (NUH2H) was started in March 2014 to provide high-quality person-centered interdisciplinary care for older adults who were discharged from the National University Hospital (NUH) Singapore. It aims to enhance the quality and safety of post-discharge care at home, leading to an eventual reduction in readmissions and prolonged hospital stay. In the first year of implementation, there was a 67%. 68% and 75% reduction in readmissions, emergency room visits and length of hospital stay respectively.
体弱的老年患者住院后需要更长的时间来康复，而且尽管他们需要复杂的护理，但出院回家时往往得不到什么支持。如果管理不当，他们特别容易受到住院风险和护理碎片化的影响。2014年3月启动了一项由老年病医生主导的过渡性护理项目，名为“国大医院到家”（NUH2H），为从新加坡国立大学医院（NUH）出院的老年人提供高质量的以人为本的跨学科护理。其目的是提高出院后在家护理的质量和安全性，最终减少再次入院和延长住院时间。在实施的第一年，再次入院、急诊就诊和住院时间分别减少了67%、68%和75%。
