Published online by Cambridge University Press: 14 July 2022
Care of the rapidly growing segment of older adults living longer with complex health and social needs remains fragmented, costly, and, at times, harmful. A high proportion of the total health care dollars consumed by this group is the result of preventable breakdowns in care experienced during frequent episodes of acute illness. Major changes in health and social systems are urgently needed to improve the quality of care delivered to these patients and control growth in health care spending. Widespread implementation of evidence-based transitional care interventions represents an immediate opportunity to better align care with older adults’ preferences and needs, enhance their health and quality of life, and reduce their use of high-cost services. Transitional care encompasses a time-limited, broad range of services to support patients at high risk for poor outcomes, and their families as they move between levels and settings of care.1
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