Continuity of care is a term that describes a situation where all of the people involved in a person’s health care, including the person receiving care, communicate and work together to coordinate health care so that changes in practitioners and places of care could occur without disrupting health care quality. In today’s health care environment, older adults are likely to see several different health care practitioners, each of whom provides different, sometimes conflicting, recommendations. Having many different practitioners could also mean that diagnostic tests are repeated, inappropriate treatments or drugs are offered, or patients become overwhelmed by the sheer number of medical opinions.

In a recent issue of the Journal of the American Medical Association, researchers from the University of Texas Medical Branch in Galveston and their colleagues described the continuity of care for older adults who transition from outpatient care to hospitalization. They examined information from over 3 million hospital admissions between 1996 and 2006 among Medicare beneficiaries over the age of 66 years. The researchers found that, in 1996, just over half (50.5%) of hospitalized patients were seen by at least 1 of the physicians they had visited as an outpatient in the prior year. Approximately 44% of patients were seen by their primary care provider while they were in the hospital. By 2006, these percentages had decreased to 39.8% and 31.9%, respectively.

Although the researchers did not evaluate whether this decrease in continuity with an outpatient physician affected the clinical outcomes of hospitalization, this study highlights the increasing fragmentation of the health care system.

Source: JAMA. 2009;301(16):1671-1680.