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There were large variations in continuity of care among different hospitals and geographic areas. In the highest decile of hospitals, the adjusted mean percentage of patients receiving all generalist care from one physician was  84.1%, vs.  24.1% in the lowest decile. This large degree of variation persisted when hospitals were stratified by size, ownership, location or teaching status. Continuity of care provided by generalist physicians to medical inpatients varies widely among hospitals. The impact of this variation on quality o