Do Hospitalizations Disrupt Loyalty to Ambulatory Care Providers?

Abstract

We sought to determine whether hospitalizations affect where patients seek ambulatory care. We conducted a retrospective cohort study of 569 adults who were attributed by a commercial payer to a large physician organization (PO) and hospitalized in 2015. Approximately half of the patients (55%) were admitted to the hospital affiliated with the PO; the rest were hospitalized elsewhere. Patients hospitalized elsewhere were significantly less likely to be seen by a PO provider in the 6 months posthospitalization than those hospitalized at the affiliated hospital (adjusted odds ratio = 0.29; 95% confidence interval = 0.17-0.48). These results have important implications for population management.

Community care emergency room use and specialty care leakage from Veterans Health Administration hospitals

“…EDs are the major source of hospital admissions 15 . After inpatient hospitalization from the ED, patients are less likely to return to their original health system or network, because they are more inclined to seek immediate care from providers connected to the system where they were admitted 16 . Providers also tend to share patients with peers within their health system and network 17 .…”

“…15 After inpatient hospitalization from the ED, patients are less likely to return to their original health system or network, because they are more inclined to seek immediate care from providers connected to the system where they were admitted. 16 Providers also tend to share patients with peers within their health system and network. 17 Thus, out-of-system ED use may act as a major source of care leakage through its effect on hospital admissions and subsequent specialty care use, 18 although to our knowledge, this relationship has not been formally investigated and quantified.…”