TiRR Memorial Hermann, 1333 Moursund, Houston, TX 77030, USA.
Physical Medicine and Rehabilitation, Neurology and Neurotherapeutics, Population and Data Sciences, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9055, USA.
Nurs Clin North Am. 2019 Sep;54(3):357-366. doi: 10.1016/j.cnur.2019.04.004. Epub 2019 May 24.
Transitions of care from acute hospitalization to postacute rehabilitation settings evolved as a function of cost-saving changes to the Medicare Prospective Payment System. Restricted criteria for inpatient rehabilitation facility admission limited access for patients with severe physical and cognitive deficits. Once used as a resource-intense supplement to hospital care, skilled nursing facilities have metamorphosed into rehabilitation settings with limited nursing staff, lower intensity of therapies, and decreased community discharge rates. A collaborative approach to care transitions, using acute and postacute health care providers, provides the opportunity to improve this process. Early physiatry consultation is a strategy for patients with neurologic disease.
从急性住院治疗到康复后治疗机构的医疗转移，是作为医疗保险预付制成本节约变化的结果而发展起来的。限制住院康复机构入院的标准限制了严重身体和认知缺陷患者的治疗途径。曾经作为医院治疗资源密集型的补充，熟练护理设施已经转变为康复设施，其护理人员减少，治疗强度降低，社区出院率降低。使用急性和康复医疗保健提供者的协作方法来进行治疗转移，可以提供改善这一过程的机会。早期物理医学咨询是神经疾病患者的一种策略。
