title: Association of weekend continuity of care with hospital length of stay.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the association of physician continuity of care with length of stay, likelihood of weekend discharge, in-hospital mortality and 30-day readmission.
  
  
  METHODS
  A cohort study of hospitalized medical patients. The primary exposure was the weekend usual provider continuity (UPC) over the initial weekend of care. This metric was adapted from an outpatient continuity of care index. Regression models were developed to determine the association between UPC and outcomes.
  
  
  METHODS
  An academic medical center.
  
  
  METHODS
  Length of stay which was calculated as the number of days from the first Saturday of the hospitalization to the day of discharge.
  
  
  RESULTS
  Of the 3391 patients included in this study, the prevalence of low, moderate and high UPC for the initial weekend of hospitalization was 58.7, 22.3 and 19.1%, respectively. When compared with low continuity of care, both moderate and high continuity of care were associated with reduced length of stay, with adjusted rate ratios of 0.92 (95% CI 0.86-1.00) and 0.64 (95% CI 0.53-0.76), respectively. High continuity of care was associated with likelihood of weekend discharge (adjusted odds ratio 2.84, 95% CI 2.11-3.83) but was not significantly associated with mortality (adjusted odds ratio 0.72, 95% CI 0.29-1.80) or readmission (adjusted odds ratio 0.88, 95% CI 0.68-1.14) when compared with low continuity of care.
  
  
  CONCLUSIONS
  Increased weekend continuity of care is associated with reduced length of stay. Improvement in weekend cross-coverage and patient handoffs may be useful to improve clinical outcomes.
authors.affiliation: Department of Population Health, New York University School of Medicine, New York, NY, USA Department of Medicine, New York University Langone Medical Center, New York, NY, USA.
authors.forename: Saul
authors.initials: S
authors.lastname: Blecker
authors.affiliation: Department of Medicine, New York University Langone Medical Center, New York, NY, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Shine
authors.affiliation: Department of Population Health, New York University School of Medicine, New York, NY, USA.
authors.forename: Naeun
authors.initials: N
authors.lastname: Park
authors.affiliation: Department of Population Health, New York University School of Medicine, New York, NY, USA.
authors.forename: Keith
authors.initials: K
authors.lastname: Goldfeld
authors.affiliation: Department of Population Health, New York University School of Medicine, New York, NY, USA Department of Medicine, New York University Langone Medical Center, New York, NY, USA.
authors.forename: R
authors.initials: R
authors.lastname: Scott Braithwaite
authors.affiliation: Department of Medicine, New York University Langone Medical Center, New York, NY, USA.
authors.forename: Martha J
authors.initials: MJ
authors.lastname: Radford
authors.affiliation: Department of Population Health, New York University School of Medicine, New York, NY, USA.
authors.forename: Marc N
authors.initials: MN
authors.lastname: Gourevitch
mesh_terms: D000046:Academic Medical Centers; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D013997:Time Factors
keywords: continuity of care; hospital; length of stay