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Invited Commentary
March 2017

Fragmentation of Care—The Untold Story

Author Affiliations
  • 1Trauma/Critical Care, Department of Surgery, University of California–San Francisco, San Francisco General Hospital
  • 2Department of Surgery, University of California–San Francisco
JAMA Surg. 2017;152(3):249-250. doi:10.1001/jamasurg.2016.4099

Havens and colleagues1 have consistently produced interesting work analyzing large patient databases. This study suggests that certain institutional factors were associated with fragmentation of surgical care in emergency surgery patients; these include hospital size, teaching status, and safety-net standing.1 However, inherent to the study design, there tends to be more questions than answers. It is difficult to come to definitive conclusions because there are several variables at play that contribute to the discontinuity of surgical care.

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