Design: National retrospective cohort
Population: 69,081 Australians aged 65 or over entering long-term care in 2019
Primary outcome: Transitional and post-entry continuity of primary care
Effect: Provider change 72% (facility) vs 10% (home-based); post-entry usual provider 78–80% of visits

This Australian national cohort followed 69,081 people aged 65 or over who entered long-term care in 2019: 41,166 into residential facilities and 27,915 into home-based packages.

72% of those entering facilities switched to a new primary care provider, against 10% receiving care at home. Switching was more common in metropolitan than non-metropolitan areas, suggesting it reflects how care is organised as much as the move itself. After entry, continuity was high in both groups, with 78–80% of visits from one usual provider.

The handover at entry is therefore the vulnerable moment. A new GP inherits a frail patient, often with multimorbidity, polypharmacy and advance care decisions, sometimes without the history that took years to build.

Send a structured summary when a patient moves into residential care, including goals of care.
Include the medication list with reasons for each drug and any deprescribing already tried.
Record advance care plans and who holds decision-making authority.
Offer a handover call to the new GP for complex patients.

Why it matters

Most continuity is lost in one transition, not gradually, which makes it a fixable moment.

The statistics, in plain English

The 72% and 10% are simple proportions in a national dataset, not adjusted effects. The Usual Provider Index of 78–80% means about four in five visits were with the same clinician after entry.