Continuity of care between family practice physicians and hospitalist services.

PURPOSE

Hospitalist services are increasing in popularity and fewer primary care providers (PCPs) are caring for patients while hospitalized. Due to concerns with discontinuity of care, this study evaluated communication and medication discrepancies on admission and discharge between PCPs without admitting privileges and hospitalist physicians.

METHODS

This retrospective analysis evaluated patients from a PCP office admitted to hospitalist services from January 2009 through July 2009. Patient charts were evaluated for PCP, age, gender, insurance, modes and timeliness of PCP notification, medications on admission and discharge, and medication discrepancies.

RESULTS

A total of 120 charts were evaluated. Physicians were contacted by receipt of admission summaries for 93% of patients and by phone for 5.8% of patients. Twenty-one percent of admission summaries were received by the PCP after the patient was discharged from the hospital and 7% of discharge summaries were received after the first hospital follow-up with the PCP. Medication errors occurred frequently and the rate increased in patients at least 65 years old, if they had Medicare, Medicaid, or were without insurance coverage.

CONCLUSION

Better communication and documentation of medication regimens are needed to improve continuity of care of patients between outpatient and inpatient settings and avoid potentially harmful medication errors.