A bridge between a hospital and home, symbolizing care transition.

Care Transitions in Latin America: Bridging the Gaps for Better Health

Rhea Morgan in Health & Wellness December 2025 • 4 min read.

"Discover how Latin American countries are strategizing to improve healthcare transitions and ensure continuity of patient care."

In today's healthcare landscape, integrating services and systems is a crucial yet challenging endeavor. The ultimate goal is to enhance healthcare quality and ensure resources are used effectively. Integrated health services aim to provide a seamless continuum of care, encompassing health promotion, disease prevention, diagnosis, treatment, disease management, rehabilitation, and palliative care across various levels and settings.

One of the key principles of health systems integration is care transition – a set of planned actions designed to ensure the safe coordination and continuity of care when patients experience changes in their health status or move between different healthcare settings. Effective care transitions can reduce hospital stays, lower readmission rates, decrease healthcare costs, and improve the quality of life for patients and their families, especially those with multiple comorbidities.

While models and programs for improving care transitions exist internationally, there's a noticeable gap in research and implementation within Brazil and Latin America. This article aims to explore care transition strategies currently employed in Latin American countries, shedding light on their approaches and potential for improvement.

What Strategies are Used in Latin America for Care Transition?

A bridge between a hospital and home, symbolizing care transition.

To understand the landscape of care transition strategies in Latin America, a comprehensive review of available literature was conducted. This involved examining studies indexed in databases such as PubMed, LILACS, Web of Science, CINAHL, SCOPUS, and SciELO, focusing on articles published in Portuguese, Spanish, or English between 2010 and 2017.

The review identified eleven relevant articles, which revealed several key strategies grouped into specific components of care transition:

Discharge Planning: Preparing patients and their families for the transition from hospital to home.
Advanced Care Planning: Discussing and documenting patient preferences for future care.
Patient Education and Self-Management: Empowering patients to manage their health conditions effectively.
Medication Safety: Ensuring patients understand their medications and how to take them correctly.
Complete Communication of Information: Sharing relevant patient information between healthcare providers.
Outpatient Follow-Up: Providing ongoing support and monitoring after discharge.

These strategies are typically implemented by multidisciplinary teams, with nurses often playing a pivotal role in ensuring safe and effective care transitions.

Key Takeaways and Future Directions

The review highlighted that care transition activities in Latin America are often initiated close to the point of patient discharge. This contrasts with recommendations from established care transition programs and models, which advocate for implementing strategies from the time of admission through discharge.

Several challenges remain in coordinating care between different levels of healthcare, including a lack of standardized processes and communication breakdowns between healthcare professionals. However, the strategies identified in this review align with interventions and recommendations from recognized programs and models, suggesting a foundation for improvement.

Moving forward, it's essential to systematically structure and implement these strategies within health services and systems. Future research should focus on evaluating the effectiveness of various care transition strategies in Latin America to identify best practices and improve patient outcomes.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1590/1983-1447.2018.20180119, Alternate LINK

Title: Care Transition Strategies In Latin American Countries: An Integrative Review

Subject: General Medicine

Journal: Revista Gaúcha de Enfermagem

Publisher: FapUNIFESP (SciELO)

Authors: Maria Alice Dias Da Silva Lima, Ana Maria Müller De Magalhães, Nelly Donszelmann Oelke, Giselda Quintana Marques, Elisiane Lorenzini, Luciana Andressa Feil Weber, Iris Fan

Published: 2018-11-29

Everything You Need To Know

What specific strategies are being used in Latin America to help patients transition between different healthcare settings?

In Latin America, several key strategies are used for care transition, including discharge planning to prepare patients for transitioning from the hospital to their home, advanced care planning to document patient preferences for future care, patient education and self-management to empower patients to manage their health conditions, medication safety to ensure patients understand their medications, complete communication of information between healthcare providers, and outpatient follow-up to provide ongoing support after discharge.

What's the purpose of integrated health services, and how do care transitions contribute to achieving this goal?

Health systems integration aims to provide a seamless continuum of care, encompassing health promotion, disease prevention, diagnosis, treatment, disease management, rehabilitation, and palliative care across various levels and settings. Effective care transitions, a key principle within health systems integration, can reduce hospital stays, lower readmission rates, decrease healthcare costs, and improve the quality of life for patients and their families, especially those with multiple comorbidities.

Who is typically involved in carrying out care transition strategies in Latin America, and when do these activities usually begin?

Multidisciplinary teams, particularly nurses, typically implement care transition strategies. However, the review found that care transition activities in Latin America are often initiated close to the point of patient discharge. This contrasts with recommendations from established care transition programs and models, which advocate for implementing strategies from the time of admission through discharge.

How do care transition practices in Latin America compare with established international models, and what are the potential implications of these differences?

The review revealed that current care transition activities in Latin America primarily focus on actions initiated close to patient discharge. This approach differs from established international care transition models, which emphasize the importance of starting interventions from the point of admission. A more comprehensive approach, beginning at admission, could lead to improved patient outcomes and a more seamless continuum of care.

What key areas are missing or under-explored in current care transition strategies in Latin America that could be important for better patient outcomes?

While research highlights strategies such as discharge planning, advanced care planning, and medication safety, crucial aspects like the integration of digital health tools for remote monitoring and telemedicine for follow-up care are less explored in the context of care transitions in Latin America. Additionally, the role of community health workers in supporting care transitions and addressing social determinants of health warrants further investigation to ensure a holistic approach to patient well-being.