Key result
Patients cared for by hospitalists with the highest schedule continuity had lower 30-day post-discharge mortality compared to those with the lowest continuity (aOR 0.88; 95% CI 0.81-0.95).
Why the study?
Hospitalist working schedules vary widely, and discontinuous schedules cause several physicians to manage a single stay, potentially worsening patient outcomes.
Does receiving care from hospitalists with more continuous schedules reduce 30-day mortality in hospitalized Medicare patients?
Population
114 777 medical admissions across 229 hospitals in Texas
Comparison
Highest vs lowest quartile of hospitalist schedule continuity
Design
Retrospective cohort study
Follow-up
30 days after discharge
Authors
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Schedule continuity was associated with lower mortality; hypothesis-generating and requires trials before practice change.
Cohort (n=114,777)
Yes
Does receiving care from hospitalists with more continuous schedules reduce 30-day mortality in hospitalized Medicare patients?
Odds Ratio: 0.88 (95% CI 0.81–0.95)
Hospitalized patients receiving care from hospitalists with more continuous schedules experience lower 30-day mortality, lower readmission rates, and lower post-discharge costs.
Goodwin et al. (2019) conducted a cohort in Medical admissions (n=114,777). Highest quartile of hospitalist schedule continuity vs. Lowest quartile of hospitalist schedule continuity was evaluated on patient mortality in the 30 days after discharge (aOR 0.88, 95% CI 0.81-0.95). Patients cared for by hospitalists with the highest schedule continuity had lower 30-day post-discharge mortality compared to those with the lowest continuity (aOR 0.88; 95% CI 0.81-0.95).
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