Triangle chronic disease stratified management model,as an effective chronic disease management model,can divide patients into different levels according to the stratified disease assessment criteria,enhance intervention effectiveness,improve management efficiency,and reduce costs by implementing targeted and personalized nursing measures.This article summarizes the overview of the Triangle chronic disease stratified management model,research progress at home and abroad,and the current application status in transitional care for chronic disease patients in order to provide a reference for medical staff to carry out transitional care for chronic disease patients.
关键词
综述/慢性病/Triangle慢性疾病分层模型/分级护理/延续护理
Key words
Review/Triangle chronic disease stratified management model/Grading nursing/Chronic diseases/Transitional care