Design: National retrospective cohort
Population: 69,081 Australians aged ≥65 entering long-term care in 2019
Primary outcome: Change of primary care provider at entry; post-entry continuity
Effect: 72% switched in facility care vs 10% home-based (p<0.001); post-entry continuity 78–80%

An Australian national cohort followed 69,081 people aged 65 or older who entered long-term care in 2019, either in a residential facility or as home-based care, and had at least three primary care visits within six months.

Of those entering a facility, 72% switched to a new GP, compared with 10% receiving care at home. The switch was more common in cities than in rural areas, which suggests the cause is how primary care is organised rather than distance alone. Once settled, continuity was high in both settings, with about 80% of visits by a usual provider.

The transition itself is the weak point. The new GP inherits a frail patient with multiple conditions and a long medication list, often without the history. A handover from the previous family doctor, a medication reconciliation and a conversation about goals of care at entry are where effort pays.

Send a written handover, including goals of care and recent medication changes, when a patient moves into a care facility.
Reconcile medicines at entry to long-term care rather than copying the old list.
Offer to remain the patient's doctor where practical, especially in rural practice.
Record advance care plans before the move, when the established relationship is strongest.

Why it matters

The move into a care home is when the doctor who knows the patient best is most often lost.

The statistics, in plain English

The 72% versus 10% contrast is large and based on national data, so it is unlikely to be chance. It is descriptive: it shows where discontinuity happens, not whether it harms outcomes.