ty -jour t1-终阶段COPD患者的出院计划和家庭护理JF-欧洲呼吸杂志JO -EUR RESSIR J SP -507 LP -512 DO -10.1183/09031936.00146308-2009/08/01 ur -http：//www.qdcxjkg.com/content/34/2/507.abstract n2-对最严重的慢性慢性阻塞性肺疾病（COPD）患者的排放支持是最小化的关键问题急性发作的影响并防止未来复发。住院治疗的替代方案对于COPD护理的成本降至最低至关重要。但是，除了效率外，还有临床原因可以促进常规医院入院的替代方案。医院留下来传达患者的风险。出院过程是医疗保健连续体的关键要素。家里的医院是医院入院的安全替代品，但这并不是支持出院的唯一手段。一些主要由护士支持的家庭护理时间表已被证明是不错的选择。家庭护理也可用于预防住院。 Integrated care is a comprehensive response to the needs of severely affected COPD patients achieved through models of shared care utilising all relevant health providers and promoting self-management. The framework for integrated care is the so-called chronic care model, centred on the promotion of self-management, the holistic appraisal of the patient, the most appropriate design of healthcare delivery responding effectively to the needs of the patient and a good system of shared and accessible information. SERIES “COMPREHENSIVE MANAGEMENT OF END-STAGE COPD” Edited by N. Ambrosino and R. Goldstein Number 7 in this Series ER -