Work Schedules of Hospitalists and Continuity of Care During Hospital Stays of Texas Medicare Patients: an Observational Study

  • James S. GoodwinEmail author
  • Jie Zhou
  • Yong-Fang Kuo
  • Ann B. Nattinger
Concise Research Reports


Work schedules for hospitalists appear to differ greatly, though the evidence is mostly anecdotal.1 Some schedules, such as seven or more consecutive days working, would promote continuity, while other schedules, like 12 h on and 36 off, would result in a hospitalized patient receiving care from multiple providers. In this paper, we describe individual hospitalist work schedules, and their association with continuity of care.


We used 100% Texas Medicare claims data for January 1, 2014, through December 31, 2014. Hospitalists (n = 2334) were identified as generalist physicians with ≥ 80% of their total Evaluation and Management Medicare charges in 2014 for hospitalized patients.2We counted each day a hospitalist billed for E&M services for a hospitalized fee-for-service Medicare patient as a working day. We calculated the percentage of each hospitalist’s total number of working days in 2014 that was part of a block of ≥ 3 or ≥ 5 or ≥ 7 consecutive working days. We...


Medicare continuity of care practice variation hospital medicine 


Author Contributions

Dr. Goodwin had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: Goodwin, Kuo, Nattinger. Draft of the manuscript: Goodwin. Critical revision of the manuscript for important intellectual content: Goodwin, Kuo, Nattinger, Zhou. Statistical analysis: Zhou, Kuo. Obtained funding: Goodwin. Supervision: Goodwin. Registration: None.


The study was funded by the National Institutes of Health (R01 AG33134 and K05 CA134923).

Compliance with Ethical Standards

Prior Presentations


Conflict of Interest

The authors declare that they do not have a conflict of interest.


The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.


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Copyright information

© Society of General Internal Medicine 2018

Authors and Affiliations

  • James S. Goodwin
    • 1
    • 2
    • 3
    Email author
  • Jie Zhou
    • 3
  • Yong-Fang Kuo
    • 2
    • 3
  • Ann B. Nattinger
    • 4
  1. 1.Department of MedicineUniversity of Texas Medical BranchGalvestonUSA
  2. 2.Department of Preventive Medicine and Community HealthUniversity of Texas Medical BranchGalvestonUSA
  3. 3.Sealy Center on Aging The University of Texas Medical BranchGalvestonUSA
  4. 4.Department of Medicine and the Center for Medical OutcomesMedical College of WisconsinMilwaukeeUSA

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