Association between physician continuity within 30 days after discharge and time to death or urgent readmission
| Observation period, mo | Physician continuity within 30 d after discharge | % with event | Events per 100 patient-years | Unadjusted HR (95% CI) | Adjusted HR* (95%CI) |
|---|---|---|---|---|---|
| 3 | No visits | 52.1 | 249 | 1.00 (ref) | 1.00 (ref) |
| All visits with unfamiliar physician(s) | 31.7 | 170 | 0.83 (0.76–0.91) | 0.92 (0.84–1.01) | |
| ≥ 1 visit with familiar physician(s) | 30.3 | 165 | 0.84 (0.80–0.88) | 0.88 (0.83–0.92) | |
| 6 | No visits | 62.9 | 201 | 1.00 (ref) | 1.00 (ref) |
| All visits with unfamiliar physician(s) | 43.6 | 128 | 0.81 (0.75–0.87) | 0.90 (0.83–0.97) | |
| ≥ 1 visit with familiar physician(s) | 43.6 | 129 | 0.84 (0.80–0.87) | 0.87 (0.83–0.91) | |
| 12 | No visits | 73.9 | 157 | 1.00 (ref) | 1.00 (ref) |
| All visits with unfamiliar physician(s) | 58.2 | 100 | 0.82 (0.76–0.87) | 0.91 (0.85–0.98) | |
| ≥ 1 visit with familiar physician(s) | 59.1 | 102 | 0.85 (0.82–0.89) | 0.89 (0.85–0.93) |
Note: CI = confidence interval, HR = hazard ratio, UPC = Usual Provider of Continuity Index, ref = referent.
↵* Covariates associated with death or urgent readmission that were included in the adjusted models at each timeframe included age, sex, length of index admission, Charlson Cormibidity Index score at discharge, number of emergency department visits for any cause in the 6 months before the index admission, number of visits to physician for any cause in the year before the index admission, residence (rural v. urban), income quintile, requirement for care in intensive care unit during index admission, specialist involvement during the index admission, number of visits to specialist for any cause before the index admission, admission to long-term care facility after discharge, and presence or absence of diabetes, atrial fibrillation, dementia, and prior myocardial infarction or coronary revascularization.