ArticleJournal of general internal medicine2015
Acute Care Utilization by Patients After Graduation of Their Resident Primary Care Physicians.
Article in Journal of general internal medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Disparities in Quality of Primary Care by Resident and Staff Physicians: Is There a Conflict Between Training and Equity?Journal of general internal medicine · 2019Article
- Continuity of Care in Resident Outpatient Clinics: A Scoping Review of the Literature.Journal of graduate medical education · 2018Article
- Transitions of Care in Continuity Clinic--Lessons Learned and Next Steps.Journal of general internal medicine · 2015Article
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4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe disruption in provider continuity caused by medical resident graduation may result in adverse patient outcomes.
objectiveOur aim was to investigate whether resident graduation was associated with increased acute care utilization by residents' primary care patients. DESIGN AND
participantsThis was a retrospective cohort study of patients cared for by junior and senior residents finishing the academic year in 2010, 2011 and 2012. MAIN MEASURES: We compared rates of clinic visits, emergency department (ED) visits, and hospitalizations between transitioning patients whose residents were graduating and non-transitioning patients whose residents were not graduating. KEY
resultsOur study population comprised 90 residents, 4018 unique patients, and 5988 resident-patient dyads that transitioned (n = 3136) or did not transition (n = 2852). For transitioning patients, the clinic visit rate per 100 patients in the 4 months before and after graduation was 129 and 102, respectively; for non-transitioning patients, the clinic visit rate was 119 and 94, respectively (difference-in-differences, +2 per 100 patients; p = 0.12). For transitioning patients, the ED visit rate per 100 patients before and after graduation was 29 and 26, respectively; for non-transitioning patients, the ED visit rate was 28 and 25, respectively (difference-in-differences, 0; p = 0.49). For transitioning patients, the hospitalization rate per 100 patients before and after graduation was 14 and 13, respectively; for non-transitioning patients, the hospitalization rate was 15 and 12, respectively (difference-in-differences, -2; p = 0.20). In multivariable modeling there was no increased risk for transitioning patients for clinic visits (adjusted rate ratio [aRR], 1.03; 95 % confidence interval [CI], 0.97 to 1.10), ED visits (aRR, 1.05; 95 % CI, 0.92 to 1.20), or hospitalizations (aRR, 1.04; 95 % CI, 0.83 to 1.31).
conclusionsAcute care utilization by residents' patients did not increase or decrease after graduation. Acute care utilization was high before and after graduation. Interventions to decrease the need for acute care should be employed throughout the year.
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