ALLERGY, RESPIRATORY
Traffic, Dust Linked to Asthma in Kids
Obesity May Raise Kids' Allergy Risk
Keep Asthma, Allergies at Bay for the Holidays
ALTERNATIVE MEDICINE
Massage Therapy Helps Those With Advanced Cancer
Could Chinese Herb Be a Natural Viagra?
Acupuncture Eases Breast Cancer Treatment Side Effects
ANIMAL CARE
Rest Easy. When It Comes to Swine Flu, Your Pet Is Safe
Separation Anxiety, Canine-Style
Safe Toys for Dogs
BONES & JOINTS
Vitamin K Doesn't Slow Bone Loss
Too Few Screened for Abdominal Aneurysm, Study Says
Bone Loss Stable on Restricted Calorie Diet
CANCER
Lifting Weights Can Ease Arm Swelling in Breast Cancer Survivors
Many Cancer Survivors Don't Adopt Healthy Lifestyle
Smoking Ups Risk of Second Breast Cancer
CAREGIVING
With Age Comes Greater Risk of Hypothermia
Weekend Admission May Be Riskier for GI Bleeding
Undoing the 'Big Baby' Trend
CIRCULATORY SYSTEM
Night Shift Work Hard on the Heart
Obesity Linked to Heart Failure Risk
Anemia Rates Down for U.S. Women and Children
COSMETIC
Mouse Study Finds Molecule That Tells Hair to Grow
What to Do If You Have Unsightly Veins
New Genetic Links to Baldness Discovered
DENTAL, ORAL
Gum Disease May Reactivate AIDS Virus
A Sweet Way to Shield Baby's Teeth
Health Tip: At Risk for Gingivitis
DIABETES
Saliva Test Could Monitor Type 2 Diabetes
Lifestyle Factors Tied to Older Adults' Diabetes Risk
Arthritis Hits More Than Half of Diabetics
DIET, NUTRITION
The Raw Food Diet
Heart Disease May Be Prevented By Taking Fish Oils, Study Shows
Functional Foods Uncovered
DISABILITIES
Review Finds Marijuana May Help MS Patients
Could Your Cell Phone Help Shield You From Alzheimer's?
ENVIRONMENTAL HEALTH
Restaurant Sushi May Have More Mercury Than Store-Bought Fare
Main Ingredients in Household Dust Come From Outdoors
Researchers ID Genetic Markers for Esophageal Cancer
EYE CARE, VISION
Ordinary Chores Cause Half of All Eye Injuries
Unconscious Learning: In the Eye of the Beholder?
Sports Eye Injuries Leading Cause of Blindness in Youths
FITNESS
Exercise Key Player in Knee Replacement Recovery
Diet, Exercise May Slow Kidney Disease Progression
Moderate Aerobic Exercise Lowers Diabetics' Liver Fat
GASTROINTESTINAL PROBLEMS
HRT Use Raises Risk of Stomach Trouble
Bowel Prep Harder on Women Than Men
New Guidelines Issued for Management of IBS
GENERAL HEALTH
Kids More Apt to Smoke If Mom Did While Pregnant
Afternoon Nap Might Make You Smarter
Dry Weather Boosts Odds of Flu Outbreaks
HEAD & NECK
Zen May Thicken Brain, Thwart Pain
Ski Helmets Encouraged for All
Many Children Will Outgrow Headaches
HEALTH & TECHNOLOGY
Magnet Therapy May Ease Hard-to-Treat Depression
Imaging Sheds Light on How Acupuncture Works
'Comfort Dogs' Come to Emotional Rescue
HEARING
Noise Hurts Men's Hearing More, Study Shows
Summer Sounds Can Lead to Hearing Loss
HEART & CARDIOVASCULAR
Review Confirms Links Between Diet, Heart Health
Cherry-Enriched Diet Cut Heart Risks in Rats
Research Shows Genetic Activity of Antioxidants
INFECTIOUS DISEASE
Hand Washing 10 Times a Day May Help Keep Flu Away
Dry Weather Boosts Odds of Flu Outbreaks
Poor Restroom Cleaning Causes Cruise-Ship Sickness
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Babies Who Eat Fish Lower Eczema Risk
Teen Stress May Have Roots in First Three Years of Life
6 Million U.S. Kids Lack Enough Vitamin D
MEN'S HEALTH
Noise Hurts Men's Hearing More, Study Shows
The Dark Side of Vegetarianism
Eating Fast Until Full Triples Overweight Risk
MENTAL HEALTH
17 Ways to Create the Perfect Workday
Consciousness Helps the Mind and Body Work Together
Music Soothes Anxiety as Well as Massage Does
PAIN
'Cell Phone Elbow' -- A New Ill for the Wired Age
Tai Chi May Help Ease Fibromyalgia
Alleviating Rheumatoid Arthritis
PHYSICAL THERAPY
PREGNANCY
Heart Defects in Newborns Linked to Antidepressants
Acupuncture May Ease Depression During Pregnancy
Yoga's Benefits Outweigh Risks for Pregnant Women
SENIORS
Older Adults May Have Some Immunity to Swine Flu
For a Healthier Retirement, Work a Little
15-Point Test Gauges Alzheimer's Risk
SEXUAL HEALTH
SLEEP DISORDERS
Pay Attention to Signs That Say You're Too Fatigued to Drive
Lose Weight, Sleep Apnea May Improve
Better Sleep, Grades Seem to Go Up
WOMEN'S HEALTH
Omega-3 May Reduce Endometriosis Risk
Women Who Run May Benefit From Extra Folic Acid
Flame-Retardant Chemical Linked to Conception Problems
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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