Care Interfaces and Transitions in the Care of people with chronic conditions
摘要
People with chronic diseases rely on a wide range of institutional and professional healthcare services. This involves not only the differing responsibilities of social benefit providers under health and social law. More importantly, those affected repeatedly encounter challenges in care due to problems in the design of care interfaces, such as lack of communication or coordination between institutions or at the interfaces themselves, given the multitude of professions and institutions involved in care. This can lead to disruptions in care, inefficient service delivery, and even adverse developments in the underlying conditions. To address this, reference is made to the tool of interface analysis, which can serve as a basis for understanding care interface problems and thus for improving the organization of inter-institutional and professional collaboration.