ALLERGY, RESPIRATORY
'Safe' Ozone Levels May Not Be for Some
Herbal Remedy Could Halt Peanut Allergy
Traffic, Dust Linked to Asthma in Kids
ALTERNATIVE MEDICINE
Acupuncture Cuts Dry Mouth in Cancer Patients
Could Chinese Herb Be a Natural Viagra?
Cranberries May Help Prevent Urinary Tract Infections
ANIMAL CARE
Separation Anxiety, Canine-Style
Rest Easy. When It Comes to Swine Flu, Your Pet Is Safe
Beware of Dog Bites
BONES & JOINTS
Stem Cells Might Treat Tough Fractures
Tai Chi May Help Ease Fibromyalgia
Improved Hip Implants Can Last 20 Years
CANCER
Bitter Melon Extract May Slow, Stop Breast Cancer
Gene Screen May Predict Colon Cancer's Return
Vitamin D May Lower Colon Cancer Risk
CAREGIVING
Injected Medication Errors a Major Problem
Mild Flu Season Coming to a Close
With Age Comes Greater Risk of Hypothermia
CIRCULATORY SYSTEM
Obesity Linked to Heart Failure Risk
A Brisk Pace May Keep Stroke at Bay
Tai Chi and Qigong Offer Many Health Benefits: Review
COSMETIC
Study Evaluates Laser Therapies for Hair Removal
The Acne Drug Accutane More Than Doubles Depression Risk
With Psoriasis, the Internet May Offer Hope
DENTAL, ORAL
Toothbrushing May Stave Off Heart Woes
Scientists Find Gene for Tooth Enamel
Health Tip: At Risk for Gingivitis
DIABETES
Older Diabetics With Depression Face Higher Death Rate
Chamomile Tea May Ward Off Diabetes Damage
Laughter May Lower Heart Attack Risk in Diabetics
DIET, NUTRITION
Weight Loss Might Not Curb Knee Arthritis
Keep Stress Off the Holiday Meal Menu, Expert Advises
Coffee Beans May Be Newest Stress-Buster
DISABILITIES
Could Your Cell Phone Help Shield You From Alzheimer's?
Review Finds Marijuana May Help MS Patients
ENVIRONMENTAL HEALTH
Small Doses of Carbon Monoxide Might Help Stroke Victims
Seasons Arriving 2 Days Earlier, Study Says
Hypertension May Hit Black Males Earlier
EYE CARE, VISION
Music Can Help Restore Stroke Patients' Sight
Cases of Age-Related Farsightedness to Soar
Blood Sugar Control Helps Diabetics Preserve Sight
FITNESS
Many Cancer Survivors Don't Adopt Healthy Lifestyle
Exercise May Prevent Prostate Cancer: Study Shows
Occupational Therapy Plus Exercise Benefits Osteoarthritis
GASTROINTESTINAL PROBLEMS
HRT Use Raises Risk of Stomach Trouble
Japanese Herbals May Ease Gastro Woes
Gum Chewing May Speed Colon Surgery Recovery
GENERAL HEALTH
Swine Flu Is Now a Pandemic Says W.H.O.
Less Education May Mean Poorer Health
Want Sun Protection? Wear Red or Blue
HEAD & NECK
Ski Helmets Encouraged for All
Zen May Thicken Brain, Thwart Pain
Many Children Will Outgrow Headaches
HEALTH & TECHNOLOGY
E-Mailing Your Way to Healthier Habits
'Cell Phone Elbow' -- A New Ill for the Wired Age
Study Suggests Link Between Cell Phones and Brain Tumors
HEARING
Summer Sounds Can Lead to Hearing Loss
Noise Hurts Men's Hearing More, Study Shows
HEART & CARDIOVASCULAR
Drinking Your Way to Health? Perhaps Not
Risk Factor for Stroke More Common Among Whites
Small Cuts in Salt Intake Spur Big Drops in Heart Trouble
INFECTIOUS DISEASE
The HPV Vaccine: Preventative Medicine or Human Sacrifice?
Swine Flu Now Reported in All 50 States
Surgical Masks Could Prevent Flu, Maybe
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Pool Chemicals Raise Kids Allergy, Asthma Risk
Mom's Extra Pregnancy Pounds May Raise Child's Heart Risks
Even Young Kids Can Learn CPR
MEN'S HEALTH
More Vitamin C May Mean Less Chance of Gout
Lots of Sex May Prevent Erectile Dysfunction
Drinking Green Tea May Slow Prostate Cancer
MENTAL HEALTH
Vitamin C Protects Some Elderly Men From Bone Loss
Love Hormone May Ease Discussion of Painful Topics
Have a Goal in Life? You Might Live Longer
PAIN
Alleviating Rheumatoid Arthritis
'Cell Phone Elbow' -- A New Ill for the Wired Age
Acupuncture, Real or Fake, Eases Back Pain
PHYSICAL THERAPY
PREGNANCY
Prenatal Stress May Boost Baby's Asthma Risk
For Baby and Mom Alike, Breast-Feeding May Be Best
Acupuncture May Relieve Acid Indigestation In Pregnancy
SENIORS
As You Age, Better Health Means Better Sex
The Healthy Habits of Centenarians
Daily dose of beet juice promotes brain health in older adults
SEXUAL HEALTH
SLEEP DISORDERS
Lose Weight, Sleep Apnea May Improve
6 to 8 Hours of Shut-Eye Is Optimal for Health
Pay Attention to Signs That Say You're Too Fatigued to Drive
WOMEN'S HEALTH
Natural Oils Help Lower Body Fat For Some
Vitamin D Deficiency Puts 40% of U.S. Infants and Toddlers At Risk
Soy May Not Lead to Denser Breasts
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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