Survey of primary care physicians and home care clinicians
- David G. FairchildAffiliated withDepartment of Medicine, the Division of General MedicineBrigham and Women’s HospitalHarvard Medical School Email author
- , Joanne HoganAffiliated withBrigham and Women’s Hospital
- , Rebecca SmithAffiliated withBrigham and Women’s Hospital
- , Michelle PortnowAffiliated withBrigham and Women’s Hospital
- , David W. BatesAffiliated withDepartment of Medicine, the Division of General MedicineBrigham and Women’s Hospital
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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.
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 wordshome care primary care communication integrated health care resource utilization
- Survey of primary care physicians and home care clinicians
Journal of General Internal Medicine
Volume 17, Issue 4 , pp 253-257
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- home care
- primary care
- integrated health care
- resource utilization
- Industry Sectors
- Author Affiliations
- 1. Department of Medicine, the Division of General Medicine, Boston, Mass
- 2. Brigham and Women’s Hospital, 75 Francis St., 02115, Boston, MA
- 3. Harvard Medical School, Boston, Mass