title: Likelihood of nursing home referral for fecally incontinent elderly patients is influenced by physician views on nursing home care and outpatient management of fecal incontinence.
abstract: OBJECTIVE
  (1) Characterize physicians' management practices for fecal incontinence (FI) among elderly patients, (2) describe physician perceptions of the quality of care for FI provided in nursing homes (NH), and (3) identify physician views and attributes associated with referral of elderly patients with FI to an NH.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  United States.
  
  
  METHODS
  Physician members of the American Geriatrics Society.
  
  
  METHODS
  Questionnaire pertaining to physician views on (1) their own FI management practices, (2) management of FI in NHs, and (3) referral of an elderly patient with FI to an NH.
  
  
  RESULTS
  Of the respondents (n = 606), 54.1% reported screening for FI and 59.3% thought FI could be managed conservatively on an outpatient basis. Only 32.9% believed NHs provide good care for FI, and 27.1% believed NH care conditions exacerbate FI. Responding to a hypothetical vignette, 10.6% would probably or definitely refer an older adult patient with only FI to an NH, and 17.2% were uncertain about whether or not to refer. Logistic regression analysis identified physician characteristics associated with decreased likelihood of NH referral as the belief that FI can be managed conservatively, the belief that NHs provide poor care for FI, longer practice experience, and practicing in an academic medical center.
  
  
  CONCLUSIONS
  Most geriatricians believe FI can be managed conservatively and that NHs provide poor care for FI. These beliefs plus longer years of practice and practice in an academic setting decrease the likelihood of referral to NH for patients with FI.
authors: Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC 27599-7080, USA.
authors: Kirsten A
authors: KA
authors: Nyrop
authors: Madhusudan
authors: M
authors: Grover
authors: Olafur S
authors: OS
authors: Palsson
authors: Steve
authors: S
authors: Heymen
authors: Mary H
authors: MH
authors: Palmer
authors: Patricia S
authors: PS
authors: Goode
authors: William E
authors: WE
authors: Whitehead
authors: Jan
authors: J
authors: Busby-Whitehead
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000379:methods; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D019468:Disease Management; D005242:Fecal Incontinence / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D005853:Geriatrics / Q000592:standards / Q000639:trends; D006707:Homes for the Aged / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians'; D011787:Quality of Health Care; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D018570:Risk Assessment; D014481:United States