1. Chen CC, Chiang YC, Lin YC, Cheng SH. Continuity of care and coordination of care: can they be differentiated? Int J Integr Care 2023;23(1):10. doi:10.5334/ijic.6467
2. Bahr SJ, Weiss ME. Clarifying model for continuity of care: a concept analysis. Int J Nurs Pract 2019;25(2): e12704. doi:10.1111/ijn.12704
3. Stašys R, Virketis G, Labanauskaitė D. The importance of the partnership between the public and private healthcare institutions to improve interhospital patient transfers. Int J Organ Anal 2021;29(6):1506-25. doi:10.1108/ijoa-07-2020-2357
4. Wagenaar B. Transfer Care System Performance in Relation to Resource Scarcity: Implications for Sustainability of the Healthcare System Performance [dissertation]. Delft University of Technology; 2023.
5. Markle-Reid M, Fisher K, Walker KM, Beauchamp M, Cameron JI, Dayler D, et al. The stroke transitional care intervention for older adults with stroke and multimorbidity: a multisite pragmatic randomized controlled trial. BMC Geriatr 2023;23(1):687. doi:10.1186/s12877-023-04403-1
6. Oksholm T, Gissum KR, Hunskår I, Augestad MT, Kyte K, Stensletten K, et al. The effect of transitions intervention to ensure patient safety and satisfaction when transferred from hospital to home health care-a systematic review. J Adv Nurs 2023;79(6):2098-118. doi:10.1111/jan.15579
7. Yaghoubi M, Behzadnezhad MM, Shaarbafchizadeh N, Javadi M, Alizade M. Post-discharge follow-up system in psychiatric patients: a case study of Farabi hospital in Isfahan. J Educ Health Promot 2023;12:302. doi:10.4103/jehp.jehp_748_22
8. Khan F, Popescu A, Chattergoon N, Fiumara F, Thandi N, Galeh H. Implementation of the admission transfer unit to reduce emergency department boarding: a quality improvement initiative. Healthc Manage Forum 2025;38(2):91-5. doi:10.1177/08404704241267317
9. Siddique SM, Tipton K, Leas B, Greysen SR, Mull NK, Lane-Fall M, et al. Interventions to reduce hospital length of stay in high-risk populations: a systematic review. JAMA Netw Open 2021;4(9): e2125846. doi:10.1001/jamanetworkopen.2021.25846
10. Habib I, Baig MK, Soomro RH. Assessing the influence of service quality on patient trust and re-visit intention: a health qual-based cross-sectional study of tertiary care hospitals in Karachi city. Center for Management Science Research 2025;3(1):190-216.
11. Gholizadeh M, Janati A, Delgoshaei B, Abulghasem Gorji H, Tourani S. Implementation requirements for patient discharge planning in health system: a qualitative study in Iran. Ethiop J Health Sci 2018;28(2):157-68. doi:10.4314/ejhs.v28i2.7
12. Bag Soytas R, Levinoff EJ, Smith L, Doventas A, Morais JA, Veronese N, et al. Predictive strategies to reduce the risk of rehospitalization with a focus on frail older adults: a narrative
review. Epidemiologia (Basel) 2023;4(4):382-407. doi:10.3390/epidemiologia4040035
13. Duggan M, Gupta A, Jackson E. The impact of the Affordable Care Act: evidence from California’s hospital sector. Am Econ J Econ Policy 2022;14(1):111-51. doi:10.1257/pol.20190279
14. Ortega A. Medicaid expansion and mental health treatment: evidence from the Affordable Care Act. Health Econ 2023;32(4):755-806. doi:10.1002/hec.4633
15. Carvalho C, Costeira CR, Pereira Sousa J. Nursing care at critical care patient inter-hospital transfer: the construction of a checklist through a scoping review. Emerg Care Med 2024;1(3):221-9. doi:10.3390/ecm1030023
16. Sartini M, Carbone A, Demartini A, Giribone L, Oliva M, Spagnolo AM, et al. Overcrowding in emergency department: causes, consequences, and solutions-a narrative review. Healthcare (Basel) 2022;10(9):1625. doi:10.3390/healthcare10091625
17. Strum RP, McPhee J, Wionzek M, MacDonald R. Stuck in transition: clinical and patient factors behind prolonged paramedic to emergency department transfer of care. Prehosp Emerg Care 2026;30(1):47-54. doi:10.1080/10903127.2025.2451217
18. Omonaiye O, Ward-Stockham K, Darzins P, Kitt C, Newnham E, Taylor NF, et al. Hospital discharge processes: insights from patients, caregivers, and staff in an Australian healthcare setting. PLoS One 2024;19(9): e0308042. doi:10.1371/journal. pone.0308042
19. Ordona RB. Transition of care challenges and opportunities for chronic wounds. Nurs Clin North Am 2025;60(1):153-63. doi:10.1016/j.cnur.2024.07.014
20. Sereeyotin J, Robinson H, Detsky ME, Soong C, Kennedy E, Eta- Ndu C, et al. Development of a patient-oriented transfer tool for transition from the intensive care unit to the ward: a mixed methods study. Can J Anaesth 2025;72(2):334-44. doi:10.1007/s12630-024-02890-3
21. Hashemian M, Salami Z, Azizpour I, Mirzaei A. Evaluation of the safety status of intrahospital transfer of critically ill patients from the perspective of emergency and ICU nurses: a crosssectional study in Iran. BMJ Open 2023;13(10): e072584. doi:10.1136/bmjopen-2023-072584
22. Jamsahar M, Ahmadi F, Khoobi M, Vaismoradi M. Managing the process of patient transfer by emergency care providers: a qualitative study. Int Emerg Nurs 2024;75:101473. doi:10.1016/j.ienj.2024.101473
23. Alizadeh Sharafi R, Ghahramanian A, Sheikhalipour Z, Ghafourifard M, Ghasempour M. Improving the safety and quality of the intra-hospital transport of critically ill patients. Nurs Crit Care 2021;26(4):244-52. doi:10.1111/nicc.12527
24. Sajadi HS, Safikhani H, Olyaeemanesh A, Majdzadeh R. Challenges in institutionalizing evidence-informed priority setting for health service packages: a qualitative document and interview analysis from Iran. Health Res Policy Syst 2024;22(1):110. doi:10.1186/s12961-024-01207-6
25. Hajalizadeh A, Ahmadinejad M, Dehghan M, Arab M. Informational needs of the families of patients discharged from intensive care units: a case of Iran. Int Q Community Health Educ 2021;41(4):379-86. doi:10.1177/0272684x20972641
26. Smith H, Grindey C, Hague I, Newbould L, Brown L, Clegg A, et al. Reducing delayed transfer of care in older people: a qualitative study of barriers and facilitators to shorter hospital stays. Health Expect 2022;25(6):2628-44. doi:10.1111/hex.13588
27. Chua CM, Ko SQ, Lai YF, Lim YW, Shorey S. Perceptions of hospital-at-home among stakeholders: a meta-synthesis. J Gen Intern Med 2022;37(3):637-50. doi:10.1007/s11606-021-07065-0
28. Patel HY, West DJ Jr. Hospital at home: an evolving model for comprehensive healthcare. Glob J Qual Saf Healthc 2021;4(4):141-6. doi:10.36401/jqsh-21-4
29. Kanagala SG, Gupta V, Kumawat S, Anamika FN, McGillen B, Jain R. Hospital at home: emergence of a high-value model of care delivery. Egypt J Intern Med 2023;35(1):21. doi:10.1186/s43162-023-00206-3
30. Heimdal SJ, Moi AL, Benestad MR, Beisland EG. Nurses’ experiences of implementing a hospital-managed home-care programme for preterm infants and their parents. J Neonatal Nurs 2025;31(1):229-37. doi:10.1016/j.jnn.2024.07.029
31. Jones J, Durey A, Strobel N, McAuley K, Edmond K, Coffin J, et al. Perspectives of health service providers in delivering bestpractice care for Aboriginal mothers and their babies during the postnatal period. BMC Pregnancy Childbirth 2023;23(1):8. doi:10.1186/s12884-022-05136-6
32. Castro GM. Patient safety in the home. Home Healthc Now 2019;37(6):365-6. doi:10.1097/nhh.0000000000000829
33. Coupland H, Moensted ML, Reid S, White B, Eastwood J, Haber P, et al. Developing a model of care for substance use in pregnancy and parenting services, Sydney, Australia: service provider perspectives. J Subst Abuse Treat 2021;131:108420. doi:10.1016/j.jsat.2021.108420
34. Meiring-Noordstra A, van der Meulen IC, Onrust M, Hafsteinsdóttir TB, Luttik ML. Relatives’ experiences of the transition from intensive care to home for acutely admitted intensive care patients-a qualitative study. Nurs Crit Care 2024;29(1):117-24. doi:10.1111/nicc.12918
35. Sørstrøm AK, Ludvigsen MS, Kymre IG. Facilitating planned home death: a qualitative study on home care nurses’ experiences of enablers and barriers. J Adv Nurs 2025;81(1):340-52. doi:10.1111/jan.16171
36. Ellis A, Taylor M. A qualitative analysis of the role of the hospital in the home registered nurse in Australia. Collegian 2025;32(1):1-8. doi:10.1016/j.colegn.2024.09.004
37. Nysæter TM, Olsson C, Sandsdalen T, Wilde-Larsson B, Hov R, Larsson M. Preferences for home care to enable home death among adult patients with cancer in late palliative phase – a grounded theory study. BMC Palliat Care 2022;21(1):49. doi:10.1186/s12904-022-00939-y
38. Klein S. “Hospital at Home” Programs Improve Outcomes, Lower Costs but Face Resistance from Providers and Payers. The Commonwealth Fund; 2021. Available from:
https://www.commonwealthfund.org/publications/newsletter-article/hospital-home-programs-improve-outcomes-lower-costs-faceresistance. Accessed February 3, 2021.
39. Levine DM, Ouchi K, Blanchfield B, Saenz A, Burke K, Paz M, et al. Hospital-level care at home for acutely ill adults: a randomized controlled trial. Ann Intern Med 2020;172(2):77-85. doi:10.7326/m19-0600