Navigation Links
Transition From Home to Hospital Rarely Seamless

Continuity of care between primary physician and hospital is decreasing, study finds,,,,

TUESDAY, April 21 (HealthDay News) -- In an ideal world, your primary-care physician would be the one who directed your health care whether you were home or in the hospital, enhancing your comfort level.

But, in reality, that type of seamless care is on the decline -- at least for older Americans.

A new study found that among Medicare patients, continuity of care was lacking, with only about one-third of those hospitalized seen by their own physician while they were in the hospital.

"Patients should know that it is very unlikely that you will be taken care of by your outpatient physician during a hospitalization," said the study's lead author, Dr. Gulshan Sharma, an assistant professor of medicine at the University of Texas Medical Branch at Galveston.

According to the study, published in the April 22/29 issue of the Journal of the American Medical Association, continuity of care is comprised of three components:

  • Continuity in information.
  • Continuity in health-care management.
  • Continuity in the physician-patient relationship.

These factors could be especially important for older patients who may have more chronic illness and may need a higher level of medical management and shared decision-making, according to the study.

"For patients, particularly geriatric patients with complex medical needs, continuity of care is probably ideal," said Dr. Laurie Jacobs, director of the Resnick Gerontology Center at Montefiore Medical Center and Albert Einstein College of Medicine in New York City. "Given a choice, anyone would want someone they know, someone they trust and someone they've communicated with in the past. But it's not always medically necessary, even though it might be ideal."

Jacobs added that this kind of continuity of care isn't always possible in the current health-care setting. "From the physician and the health-system perspective, it's difficult to practice in an ideal fashion," she noted. She said fewer doctors are choosing to go into primary care and that reimbursement issues often limit physicians. Also, many medical centers have moved to a "hospitalist" model, where a doctor on staff at the hospital is in charge of a patient's care.

For the new study, Sharma and his colleagues reviewed a national sample of Medicare claims that included more than 3 million hospital admissions from 1996 through 2006. All of the participants were older than 66 years.

In 1996, the researchers found, 50.5 percent of people hospitalized were seen by at least one physician they had seen as an outpatient. By 2006, that number had dropped to 39.8 percent.

They also found that 44.3 percent of people who said they had a primary-care physician were seen by that doctor in a hospital in 1996. Ten years later, that percentage was down to 31.9 percent. People living in large metropolitan areas and those being seen in large teaching hospitals were the least likely to be seen by their primary care physician, according to the study.

Although people may assume their regular physician and the hospital doctors are in communication, Sharma said that's often not the case. "Post-discharge communication is very poor. It only occurs about 20 percent of the time," he said.

Both Sharma and Jacobs said the health-care system is shifting to the hospitalist model, and that electronic medical records would go a long way toward bridging the communication gap between outpatient and inpatient care.

More information

For more on hospital care, visit the U.S. Department of Health and Human Services.

SOURCES: Gulshan Sharma, M.D., M.P.H., assistant professor of medicine, University of Texas Medical Branch at Galveston; Laurie G. Jacobs, M.D., professor of clinical medicine, and division head, geriatrics, and director, Resnick Gerontology Center, Albert Einstein College of Medicine and Montefiore Medical Center, New York City; April 22/29, 2009, Journal of the American Medical Association

Copyright©2009 ScoutNews,LLC.
All rights reserved

Related medicine news :

1. iMedica Launches Transition™, a New, Streamlined EHR That Breaks Down the Barriers to Physician Adoption and Use
2. HCSC Discusses the Controversial ICD-10 Transition at the 2009 HIMSS Conference
3. The Quantum Group Announces Transition to Continental Stock Transfer
4. iMedica and Imagetek Team up to Ease Transition to Paperless Medical Practice
5. iMedica and Imagetek Team Up to Ease Transition to Paperless Medical Practice
6. Northeastern Hospital to Transition to Northeastern Ambulatory Care Center
7. Transition Therapeutics Announces Initiation of a Phase Ib Clinical Study of TT-223 in combination with a GLP-1 analogue in Patients with Type 2 Diabetes
8. Mylan Announces Transition of Chief Financial Officer
9. Transition Therapeutics Announces Second Quarter Fiscal 2009 Financial Results
10. Transition Therapeutics to Hold Conference Call on Second Quarter Fiscal 2009 Financial Results on Wednesday, February 11th, at 4:30 P.M. EST
11. CDS Completes Large-Scale Transition of Medicare Data Processing
Post Your Comments:
(Date:11/27/2015)... ... November 27, 2015 , ... ... Microsoft Dynamics SL User Group (MSDSLUG). Recognized as Microsoft’s official group for end ... Microsoft Dynamics SL software users, partners, industry experts and representatives. Intellitec Solutions’ membership ...
(Date:11/27/2015)... ... November 27, 2015 , ... The moment you ... for not only fulfilling the needs of advisers and clients but going above ... and providing top-tier customer service. However, there's always room for improvement, which is ...
(Date:11/27/2015)... ... , ... CBD College is proud to announce that on November ... to its Diagnostic Medical Sonography program. CBD College is honored to join this very ... and universities in the state of California make the cut. CBD College is officially ...
(Date:11/27/2015)... ... , ... Dr. Thomas Dunlap and Dr. Patrick Coleman , ... Emergency Medicine at St., Joseph Health System’s Santa Rosa Memorial Hospital , co-hosted ... similar ways and require time-critical intervention to avoid large area heart damage and progressive ...
(Date:11/27/2015)... ... 27, 2015 , ... Indosoft Inc., developer and distributor of ... 11 LTS (Long Term Support) into its Q-Suite 5.10 product line. , Making ... with a version of Asterisk that will receive not only security fixes, but ...
Breaking Medicine News(10 mins):
(Date:11/27/2015)... YORK , November 27, 2015 ... system is set to go online. The potential to ... processes is vast and far from fully exploited as ... to patient health records, either via mobile tablet or ... ) --> ) --> ...
(Date:11/27/2015)... ) ... "2016 Global Tumor Marker Testing Market: Supplier ... Segment Forecasts, Innovative Technologies, Instrumentation Review, Competitive ... offering. --> ) has ... Global Tumor Marker Testing Market: Supplier Shares ...
(Date:11/26/2015)... Netherlands , November 26, 2015 ... A new combination approach blends immunotherapy with Bremachlorin-photodynamic ... A new combination approach blends immunotherapy with Bremachlorin-photodynamic therapy ... A new combination approach blends immunotherapy with Bremachlorin-photodynamic therapy ... Netherlands has found that immunotherapy can be ...
Breaking Medicine Technology: