title: Managing patient care transitions: a report of the HMO Care Management Workgroup.
authors.affiliation: University of Colorado Health Sciences Center, USA.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Coleman
authors.forename: Peter D
authors.initials: PD
authors.lastname: Fox
mesh_terms: D000368:Aged; D003266:Continuity of Patient Care; D006279:Health Maintenance Organizations / Q000458:organization & administration*; D006301:Health Services Needs and Demand; D006801:Humans; D008498:Medical Record Linkage; D010351:Patient Discharge; D010360:Patient Transfer; D010817:Physician-Patient Relations; D011361:Professional Competence; D012866:Skilled Nursing Facilities / Q000458:organization & administration*; D012941:Social Responsibility; D014481:United States