Transitions of Care and Their Importance on Value-Based Healthcare

摘要

Healthcare is in a state of transition and reform. As healthcare spending increases disproportionally to patient outcomes, more emphasis is being placed on the overall value of healthcare. As healthcare transitions away from fee-for-service models to value-based models, healthcare organizations must explore programs and initiatives that enhance value through increased patient outcomes, increased patient experiences, and decreased overall costs. Although many value enhancing opportunities exist in many healthcare settings, hospital discharge care transitions represent a critical time when patients are prone to adverse effects and ineffective and inappropriate care post-discharge, which can lead to possible hospital readmissions. Solutions to maximizing value-based healthcare during discharge care transitions include pharmacist managed discharge medication reconciliation and education, discharge prescription drug programs, and post-discharge follow-up management by a community paramedic or pharmacist. This paper presents these solutions and the implementation and evaluation of a value-based healthcare discharge care transition program through a logic model structure.