U.S. Department of Health and Human Services

National Diabetes Education Program

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Improve Patient Care Coordination

Care coordination involves patient referral for specialized services by a medical/surgical or specialist consultant or community agency or transition between providers or institutions such as hospital to primary care, or pediatric to adult care. Quality chronic care integrates clinic and community-based services in order to address the comprehensive medical and health needs of people who are served. “Such a system provides the comprehensive model on which the quality of both health promotion and chronic illness care depend.” [1]

This section addresses ways to improve coordination of care and to enhance community partnerships. Numerous resources are included.