Navigation Links
Transition From Home to Hospital Rarely Seamless
Date:4/21/2009

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:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... (PRWEB) , ... October 13, 2017 , ... ... agency serving communities in the greater Dallas, Miami, and Raleigh regions, is organizing ... fighting to overcome a rare and deadly chromosome abnormality. , After struggling since ...
(Date:10/13/2017)... ... October 13, 2017 , ... As health professionals work to improve ... engagement.” The patient is doing more than filling out a survey; in many cases ... an increasing emphasis in health care and research on the importance of active engagement ...
(Date:10/13/2017)... LEXINGTON, Ky. (PRWEB) , ... October 13, 2017 , ... ... MD, MPH to become its next President and Chief Executive Officer, succeeding Dr. James ... and CEO Elect beginning July 1, 2018 until Dr. Puffer’s retirement at the end ...
(Date:10/13/2017)... ... October 13, 2017 , ... PurhealthRX , a ... utilizing Purzorb™ technology. Applying the Purzorb™process to full spectrum CBD oil will revolutionize the ... a CBD form that can be easily incorporated into liquid products, while reducing costs ...
(Date:10/13/2017)... ... ... Lori R. Somekh, founder of the Law Office of Somekh & Associates ... special needs planning attorneys. “Membership in ElderCounsel helps our office remain up to date ... elder law attorneys nationwide,” said Somekh. , ElderCounsel was founded by ...
Breaking Medicine News(10 mins):
(Date:10/2/2017)... INDIANAPOLIS , Oct. 2, 2017  Eli Lilly ... its financial results for the third quarter of 2017 ... a conference call on that day with the investment ... performance. The conference call will begin at ... public can access a live webcast of the conference ...
(Date:9/28/2017)... Cohen Veterans Bioscience and Early Signal Foundation ... and home sensors for real-time monitoring of patients with ... nonprofit organization focused on disruptive health solutions for rare ... system to record and integrate behavioral, cognitive, physiological and ... ...
(Date:9/23/2017)... 22, 2017 Janssen Biotech, Inc. (Janssen) announced ... from the U.S. Food and Drug Administration (FDA) for ... for the treatment of moderately to severely active rheumatoid ... data are needed to further evaluate the safety of ... RA. "We ...
Breaking Medicine Technology: