Survey of primary care physicians and home care clinicians.
BACKGROUND
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.


METHODS
Mail survey.


METHODS
Boston.


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


METHODS
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.
Fairchild
David G
DG
Division of General Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Mass 02115, USA. dfairchild@partners.org
Hogan
Joanne
J
Smith
Rebecca
R
Portnow
Michelle
M
Bates
David W
DW
D000328:Adult; D001291:Attitude of Health Personnel; D003142:Communication; D003266:Continuity of Patient Care; D005260:Female; D019538:Health Care Surveys; D006699:Home Care Services / Q000592:standards* / Q000639:trends; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000592:standards* / Q000639:trends; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D014505:Urban Population