Department of Emergency Medicine, Yale School of Medicine, 464 Congress Avenue, Suite 260, New Haven, CT 06519, USA; Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, CT 06519, USA.
Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, USA; Department of Medicine, Duke University School of Medicine, Box 3003, Durham, NC 27710, USA; Geriatric Research, Education, Clinical Center, Durham VA Health Care System, Durham, NC, USA; Center for the Study of Human Aging and Development, Duke University School of Medicine, Durham, NC, USA; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
Clin Geriatr Med. 2023 Nov;39(4):659-672. doi: 10.1016/j.cger.2023.05.009. Epub 2023 Jun 14.
This article describes emergency department (ED)-to-community care transitions for older adults and associated challenges, measurement, proven efficacious and effective interventions, and policy considerations. Older adults experiencing social isolation and impairments in functional status or cognition represent unique populations that are particularly at risk during ED-to-community transitions of care and may benefit from targeted intervention implementation. Future efforts should target optimizing screening techniques to identify those at risk, developing and validating patient-centered outcome measures, and using policy and reimbursement levers to include transitional care management services for older adults within the ED setting.
本文介绍了老年人在急诊部(ED)到社区护理的过渡以及相关挑战、测量、经过验证的有效干预措施和政策考虑。 那些在社会隔离、功能状态或认知方面存在障碍的老年人代表了一些独特的人群,他们在 ED 到社区的护理过渡期间面临着特别高的风险,可能会受益于有针对性的干预措施的实施。未来的努力应该集中于优化筛选技术,以识别那些有风险的人,开发和验证以患者为中心的结果测量指标,并利用政策和报销手段,将过渡性护理管理服务纳入 ED 环境中。