Variation among hospitals in the continuity of care for older hospitalized patients: a cross-sectional cohort study

Abstract Background Little is known about how continuity of care for hospitalized patients varies among hospitals. We describe the number different general internal medicine physicians seeing during a medical admission and that by hospital. Methods conducted retrospective study national 20% sample Medicare inpatients from 01/01/16 to 12/31/18. In with routine admissions (length stay 3–6 days, no Intensive Care Unit stay, seen only one generalist per day), we assessed odds receiving all generalist. calculated rates each hospital, adjusting patient hospital characteristics in multi-level logistic regression model. Results Among 3- 6-day stays, 43.1% received their same physician. those 3-day 50.1% had providing vs. 30.8% stay. two-level (admission hospital) model controlling length just did not vary greatly such as age, race/ethnicity, comorbidity or reason admission. There were large variations hospitals geographic areas. highest decile hospitals, adjusted mean percentage physician was > 84.1%, < 24.1% lowest decile. This degree variation persisted when stratified size, ownership, location teaching status. Conclusions Continuity provided widely The impact this on quality unknown.