Journal of General Internal Medicine

, Volume 17, Issue 4, pp 253–257

Survey of primary care physicians and home care clinicians

An assessment of communication and collaboration


    • Department of Medicinethe Division of General Medicine
    • Brigham and Women’s Hospital
    • Harvard Medical School
  • Joanne Hogan
    • Brigham and Women’s Hospital
  • Rebecca Smith
    • Brigham and Women’s Hospital
  • Michelle Portnow
    • Brigham and Women’s Hospital
  • David W. Bates
    • Department of Medicinethe Division of General Medicine
    • Brigham and Women’s Hospital
Original Articles

DOI: 10.1046/j.1525-1497.2002.10717.x

Cite this article as:
Fairchild, D.G., Hogan, J., Smith, R. et al. J GEN INTERN MED (2002) 17: 253. doi:10.1046/j.1525-1497.2002.10717.x


CONTEXT: Providing home care in the United States is expensive, and significant geographic variation exists in the utilization of these services. However, few data exist on how well physicians and home care providers communicate and coordinate care for patients.

OBJECTIVE: To assess communication and collaboration between primary care physicians (PCPs) and home care clinicians (HCCs) within 1 primary care network.

DESIGN: Mail survey.

SETTING: Boston.

PARTICIPANTS: Sixty-seven PCPs from 1 academic medical center-affiliated primary care network and 820 HCCs from 8 regional home care agencies.

MEASUREMENTS: Provider responses

RESULTS: Ninety percent of PCPs and 63% of HCCs responded. The majority (54%) of PCPs reported that they only “rarely” or “occasionally” read carefully the home care order forms sent to them for signature. Further, when asked to rate their prospective involvement in the decision making about home care, only 24% of PCPs and 25% of HCCs rated this as “excellent” or “very good.” Although more HCCs (79%) than PCPs (47%) reported overall satisfaction with communication and collaboration, 28% of HCCs felt they provided more services to patients than clinically necessary.

CONCLUSIONS: PCPs from 1 provider network and the HCCs with whom they coordinate home care were both dissatisfied with many aspects of communication and collaboration regarding home care services. Moreover, neither group felt in control of home care decision making. These findings are of concern because poor coordination of home care may adversely affect quality and contribute to inappropriate utilization of these services.

Key words

home careprimary carecommunicationintegrated health careresource utilization

Copyright information

© Society of General Internal Medicine 2002