ALLERGY, RESPIRATORY
Molecule in Skin May Link Eczema and Asthma
Air Pollution May Raise Blood Pressure
Overweight Moms More Likely to Have Asthmatic Kids
ALTERNATIVE MEDICINE
Many Cancer Patients Turn to Complementary Medicine
Meditation, Yoga Might Switch Off Stress Genes
Uncover Why Turmeric Helps You Heal
ANIMAL CARE
Safe Toys for Dogs
Separation Anxiety, Canine-Style
Rest Easy. When It Comes to Swine Flu, Your Pet Is Safe
BONES & JOINTS
Tips to Ease an Aching Back
Tequila Plant May Help Fight Bone Loss
Improved Hip Implants Can Last 20 Years
CANCER
Want to Stop Cancer? You Can, Experts Say
Study Suggests Link Between Cell Phones and Brain Tumors
HPV Vaccine Has Higher Allergic Reaction Rate
CAREGIVING
Bariatric Surgery Centers Don't Deliver Better Outcomes
Are Hospital Mobile Phones Dialing Up Superbugs?
Acute Respiratory Distress Syndrome as Deadly as Ever
CIRCULATORY SYSTEM
An Apple a Day May Help Keep Heart Disease Away
Firefighters Have Narrower-Than-Normal Arteries, Study Finds
Salt Boosts Blood Pressure in High-Risk Patients
COSMETIC
Study Evaluates Laser Therapies for Hair Removal
New Genetic Links to Baldness Discovered
Science May Banish Bad Hair Days
DENTAL, ORAL
Good Oral Hygiene May Protect Against Heart Infections
Gummy Bears Join Cavity Fight
Laser Technology Spots Cavities Before They Start
DIABETES
Strict Blood Sugar Lowering Won't Ease Diabetes Heart Risk
Exercise Protects Black Women From Type 2 Diabetes
Findings Challenge Tight Glucose Control for Critically Ill Patients
DIET, NUTRITION
Antioxidants Abound in Cereals, Popcorn, Whole-Grain Snacks
Healthy Eating While On Vacation
Holiday Eating Without the Guilt -- or the Pounds
DISABILITIES
Could Your Cell Phone Help Shield You From Alzheimer's?
Review Finds Marijuana May Help MS Patients
ENVIRONMENTAL HEALTH
Pollution Particles Impair Blood Vessel Function
Global Warming Linked to Heightened Kidney Stone Risk
Former Inmates at Increased Risk for High Blood Pressure
EYE CARE, VISION
Protein Might One Day Prevent Blindness
Impotence Drugs Don't Harm Vision: Study
Kids Who Spend More Time Outdoors Have Better Vision
FITNESS
Resistance Training Boosts Mobility in Knee Arthritis Patients
Living With Less TV, More Sweat Boosts Weight Loss
Simple Steps Get Walkers Moving
GASTROINTESTINAL PROBLEMS
Olive Oil May Protect Against Bowel Disease
Gum Chewing May Speed Colon Surgery Recovery
Traditional Nonsurgical GERD Treatments Not Impressive
GENERAL HEALTH
Simple Holistic Approach to Fight the Common Cold
Sun, Smoke, Extra Weight Add Years to Skin
Vitamin D Best Taken With Largest Meal of Day, Study Finds
HEAD & NECK
Zen May Thicken Brain, Thwart Pain
Many Children Will Outgrow Headaches
Ski Helmets Encouraged for All
HEALTH & TECHNOLOGY
Study Suggests Link Between Cell Phones and Brain Tumors
E-Mailing Your Way to Healthier Habits
Subway Defibrillators Save Lives
HEARING
Summer Sounds Can Lead to Hearing Loss
Noise Hurts Men's Hearing More, Study Shows
HEART & CARDIOVASCULAR
Coffee Is Generally Heart-Friendly
Cocoa in Chocolate May Be Good for the Heart
Fewer Heart Attacks After England Goes Smoke-Free
INFECTIOUS DISEASE
Swine Flu Is Now a Pandemic Says W.H.O.
More Medicinal Uses for Pomegranate
Viral Infection Might Trigger High Blood Pressure
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Meaningful Conversations Boost Kids' Language Skills
School Meals Need to Get Healthier
Scorpion Anti-Venom Speeds Children's Recovery
MEN'S HEALTH
Sunlight May Help Protect Men From Kidney Cancer
Low Vitamin D Levels May Boost Men's Heart Attack Risk
Lots of Sex May Prevent Erectile Dysfunction
MENTAL HEALTH
How to Attack Holiday Stress Head-On
Optimism May Boost Immune System
Fear Response May Stem From Protein in Brain
PAIN
Tai Chi May Help Ease Fibromyalgia
Acupuncture, Real or Fake, Eases Back Pain
Are We Exercising Pain Away? Not So Much.
PHYSICAL THERAPY
PREGNANCY
Before Conceiving, Take Folic Acid for One Full Year
Alternative Treatments May Boost IVF Success
Calcium Supplements Cut Blood Lead Levels During Pregnancy
SENIORS
Could Your Cell Phone Help Shield You From Alzheimer's?
Boost In Elderly Population Will Be Felt Worldwide
Nighttime Urination Linked to Higher Death Rate Among Elderly
SEXUAL HEALTH
SLEEP DISORDERS
6 to 8 Hours of Shut-Eye Is Optimal for Health
Moderate Aerobics May Ease Insomnia Symptoms
Meditation May Help Put Primary Insomnia to Bed
WOMEN'S HEALTH
Vitamin D Deficiency Puts 40% of U.S. Infants and Toddlers At Risk
Rheumatoid Arthritis Rising Among U.S. Women
Exercise As Well As Acupuncture, May Ease Polycystic Ovarian Syndrome
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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