Hospitalist continuity doesn't appear to greatly affect AEs

(HealthDay)—Measures of hospitalist physician continuity do not show a consistent or significant association with the incidence of adverse events (AEs), according to research published in the March issue of the Journal of Hospital Medicine.

Kevin J. O'Leary, M.D., of the Northwestern University Feinberg School of Medicine in Chicago, and colleagues conducted a retrospective observational study to examine the association between hospital physician continuity and the incidence of AEs. The analysis included data from 474 hospitalizations on a nonteaching service in a large academic hospital.

The researchers found that, in unadjusted models, each 1-unit increase in the Number of Physicians Index (NPI), representing less continuity, was significantly associated with the incidence of one or more AEs (odds ratio, 1.75; P < 0.001). In these models, the Usual Provider of Care (UPC) index was not associated with the incidence of AEs. In all adjusted models, no significant associations of NPI or UPC with incidence of AEs were found. In these models, the direction of the effect of discontinuity on the incidence of AEs also was inconsistent.

"Our findings are somewhat surprising because of the high value placed on continuity of care and patient safety concerns related to handoffs," the authors write. "We speculate that hospitalist continuity is only one of many team factors that may influence patient safety, and that prior efforts within our institution may have reduced our ability to detect an association."

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