The Importance Of Transitional Care In Achieving Health Reform

Under the Affordable Care Act of 2010, a variety of transitional care programs and services have been established to improve quality and reduce costs. These programs help hospitalized patients with complex chronic conditions-often the most vulnerable-transfer in a safe and timely manner from one lev...

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Vydané v:Health Affairs Ročník 30; číslo 4; s. 746 - 754
Hlavní autori: Naylor, Mary D., Aiken, Linda H., Kurtzman, Ellen T., Olds, Danielle M., Hirschman, Karen B.
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Chevy Chase The People to People Health Foundation, Inc., Project HOPE 01.04.2011
Predmet:
Adults
Beneficiaries
Caregivers
Case management
Chronic illnesses
Clinical research
Clinical trials
Community health care
Cost control
Cost reduction
Discharge
Domiciliary visits
Emergency medical care
Experiments
Health care policy
Health services
Hospitalization
Hospitalized
Hospitals
Inpatient care
Intervention
Literature reviews
Low income groups
Medicaid
Medicare
Patient Protection & Affordable Care Act 2010-US
Patients
Quality of care
Reforms
Social programs
Systematic review
United States > US
ISSN:0278-2715, 1544-5208
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Popis
Shrnutí:Under the Affordable Care Act of 2010, a variety of transitional care programs and services have been established to improve quality and reduce costs. These programs help hospitalized patients with complex chronic conditions-often the most vulnerable-transfer in a safe and timely manner from one level of care to another or from one type of care setting to another. We conducted a systematic review of the research literature and summarized twenty-one randomized clinical trials of transitional care interventions targeting chronically ill adults. We identified nine interventions that demonstrated positive effects on measures related to hospital readmissions-a key focus of health reform. Most of the interventions led to reductions in readmissions through at least thirty days after discharge. Many of the successful interventions shared similar features, such as assigning a nurse as the clinical manager or leader of care and including in-person home visits to discharged patients. Based on these findings, we recommend several strategies to guide the implementation of transitional care under the Affordable Care Act, such as encouraging the adoption of the most effective interventions through such programs as the Community-Based Care Transitions Program and Medicare shared savings and payment bundling experiments. [PUBLICATION ABSTRACT]
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 14
ISSN:0278-2715
1544-5208
DOI:10.1377/hlthaff.2011.0041