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An article in the Journal of the American Medical Association (JAMA) reports that between 1996 and 2006, physician continuity from outpatient to inpatient settings decreased in the Medicare population. According to the article, in 1996, 50.5% of hospitalized patients were seen by at least 1 physician that they had visited in an outpatient setting in the prior year, and 44.3% of patients with an identifiable PCP were seen by that physician while hospitalized. These percentages decreased to 39.8% and 31.9%, respectively, in 2006. Greater absolute decreases in continuity with any outpatient physician between 1996 and 2006 occurred in patients admitted on weekends and those living in large metropolitan areas and in New England. In multivariable multilevel models, increasing involvement of hospitalists was associated with approximately one-third of the decrease in continuity of care between 1996 and 2006.
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