ALLERGY, RESPIRATORY
Herbal Remedy Could Halt Peanut Allergy
New Spray Could Benefit Cystic Fibrosis Patients
Using Music and Sports to Improve Kids' Asthma
ALTERNATIVE MEDICINE
Massage Therapy Helps Those With Advanced Cancer
Acupuncture May Trigger Natural Painkiller
Maggots as Good as Gel in Leg Ulcer Treatments
ANIMAL CARE
Beware of Dog Bites
Safe Toys for Dogs
Separation Anxiety, Canine-Style
BONES & JOINTS
Winter Is Tough on Feet
For All Their Plusses, Pets Pose a Risk for Falls, Too
Get in Step With Summer Foot Care
CANCER
Gene Studies Reveal Cancer's Secrets
Gene Screen May Predict Colon Cancer's Return
Family History Key Player in Brain Cancer Risk
CAREGIVING
Are Hospital Mobile Phones Dialing Up Superbugs?
Diabetes Epidemic Now Poses Challenges for Nursing Homes
With Age Comes Greater Risk of Hypothermia
CIRCULATORY SYSTEM
Tai Chi and Qigong Offer Many Health Benefits: Review
A Brisk Pace May Keep Stroke at Bay
Walk 100 Steps a Minute for 'Moderate' Exercise
COSMETIC
Gum Chewing May Cut Craving for Snacks
Contact Lenses Boost Kids' Self-Image
Study Evaluates Laser Therapies for Hair Removal
DENTAL, ORAL
Gum Disease May Reactivate AIDS Virus
Periodontal Disease Impacts Whole Health
Mom's Vitamin D Levels Affect Baby's Dental Health
DIABETES
Brown Rice Bests White for Diabetes Prevention
Study Shows Turmeric May Prevent Type 2 Diabetes
Poor Blood Sugar Control After Heart Surgery Impacts Outcomes
DIET, NUTRITION
Pesticides on Produce Tied to ADHD in Children
Fruit Even Healthier Than Thought: Study Shows
Eat Up, But Eat Healthy This Holiday Season
DISABILITIES
Review Finds Marijuana May Help MS Patients
Could Your Cell Phone Help Shield You From Alzheimer's?
ENVIRONMENTAL HEALTH
Is It Safe to Go in the Gulf Coast's Water?
Global Warming Linked to Heightened Kidney Stone Risk
Climate Change Could Sting Allergy, Asthma Sufferers
EYE CARE, VISION
Music Can Help Restore Stroke Patients' Sight
Cases of Age-Related Farsightedness to Soar
Vision Test for Young Children Called Unreliable
FITNESS
Bursts of Vigorous Activity Appear to Be a 'Stress-Buffer'
Study Shows Exercise Shields Against Osteoporosis
As Temperature Plummets, It's Still Safe to Exercise
GASTROINTESTINAL PROBLEMS
Bowel Prep Harder on Women Than Men
Traditional Nonsurgical GERD Treatments Not Impressive
Japanese Herbals May Ease Gastro Woes
GENERAL HEALTH
It Pays to Eat Less as You Age
Hidden Salt in Diet Haunts Many With Heart Failure
Swine Flu May Pose Problems for Pregnant Women
HEAD & NECK
Zen May Thicken Brain, Thwart Pain
Ski Helmets Encouraged for All
Many Children Will Outgrow Headaches
HEALTH & TECHNOLOGY
Using Light Therapy to Silence Harmful Brain Activity
Save Your Aging Brain, Try Surfing The Web
Imaging Sheds Light on How Acupuncture Works
HEARING
Noise Hurts Men's Hearing More, Study Shows
Summer Sounds Can Lead to Hearing Loss
HEART & CARDIOVASCULAR
A Little Chocolate May Do the Heart Good
Walk Long, Slow and Often to Help the Heart
Whole Grains Lower Risk of Heart Failure
INFECTIOUS DISEASE
Swine Flu Closes Three Schools in NYC
Hand Washing 10 Times a Day May Help Keep Flu Away
Swine Flu Now Reported in All 50 States
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Wood Fires Can Harm the Youngest Lungs
Daily Exercise at School Yields Rewards
Fussy Babys Could Be Out Of Your Control
MEN'S HEALTH
Could Chinese Herb Be a Natural Viagra?
Low Iron Levels Cut Cancer Risk in Men With PAD
Soy Linked to Low Sperm Count
MENTAL HEALTH
Keeping a Healthy Holiday Balance
Green Spaces Boost the Body and the Mind
Daily dose of beet juice promotes brain health in older adults
PAIN
Tai Chi May Help Ease Fibromyalgia
Are We Exercising Pain Away? Not So Much.
Alleviating Rheumatoid Arthritis
PHYSICAL THERAPY
PREGNANCY
Woman in America Are Delaying Motherhood, Study Says
Acupuncture May Relieve Acid Indigestation In Pregnancy
Exercise Boosts Bone Density in Breast-Feeding Moms
SENIORS
The Healthy Habits of Centenarians
Laughter Can Stimulate a Dull Appetite
Boost In Elderly Population Will Be Felt Worldwide
SEXUAL HEALTH
SLEEP DISORDERS
Daylight Savings: Not a Bright Time for All
Better Sleep, Grades Seem to Go Up
6 to 8 Hours of Shut-Eye Is Optimal for Health
WOMEN'S HEALTH
Spice Compounds May Stem Tumor Growth
Broccoli May Help Battle Breast Cancer
Woman in America Are Delaying Motherhood, Study Says
Add your Article

Transition From Home to Hospital Rarely Seamless

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.

-Serena Gordon

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

Last Updated: April 21, 2009

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