Association between in‐hospital supportive visits by primary care physicians and patient outcomes: A population‐based cohort study

BACKGROUND One long‐standing method for continuity of care as patients transition between the hospital and community are supportive visits by primary care physicians during hospitalization. METHODS This retrospective cohort study used administrative data of adults hospitalized from 2008 to 2009 and primary care physicians who conduct supportive visits. Patients who received a visit from their primary care physician while hospitalized were compared to those who did not. Composite outcomes of death, emergency department visit, or emergent readmission within 30 and 90 days were assessed. Postdischarge home‐care utilization and primary care physician visits were also examined. Multivariate logistic regression models adjusted for age, sex, low income, rurality, and readmission risk. RESULTS Of the 164,059 patients linked to 3236 primary care physicians, 12.0% received visits while hospitalized. Visited patients had more readmissions, more deaths, and fewer emergency department visits than patients who did not. However, after adjusting, visited patients had a lower risk for the composite outcome at 30 days (adjusted OR [aOR]: 0.92; 95% confidence interval [CI]: 0.89‐0.96) and 90 days (aOR: 0.90; 95% CI: 0.87‐0.92). Visited patients were also more likely to access community primary care–provider visits and more home‐care services. The in‐hospital visit resulted in an increased likelihood of health services utilization at 30 days (aOR: 1.16; 95% CI: 1.11‐1.22) and 90 days (aOR: 1.20; 95% CI: 1.12‐1.27). CONCLUSION A hospital supportive‐care visit from a primary care physician resulted in lower risks of adverse patient outcomes and increased access to community health services. Journal of Hospital Medicine 2016;11:418–424. © 2016 Society of Hospital Medicine