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We also examined how fragmentation varied by patient's age, gender, race, ethnicity, marital status, rural status, history of homelessness, number of chronic conditions, Medicare utilization, and mental health care utilization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Extraction Methods<\/jats:title><jats:p>We extracted data for 130,704 VA patients \u226565\u2009years old with a hospitalization risk \u226590th percentile and\u2009\u2265\u2009four outpatient visits in the baseline year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Principal Findings<\/jats:title><jats:p>The mean (SD) of FY14 outpatient visits was 13.2 (8.6). Fragmented care (more providers, less care with a usual provider, more dispersed care based on COCI) was more common among patients with more chronic conditions and those receiving mental health care. In adjusted models, most fragmentation measures were not associated with all\u2010cause hospitalization, and patients with low levels of fragmentation (more concentrated care based on UPC, COCI, and MMCI) had a higher likelihood of an ACSC\u2010related hospitalization (AOR, 95% CI\u00a0=\u00a01.21 (1.09\u20101.35), 1.27 (1.14\u20101.42), and 1.28 (1.18\u20101.40), respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Contrary to expectations, outpatient care fragmentation was not associated with elevated all\u2010cause hospitalization rates among VA patients in the top 10th percentile for risk of admission; in fact, fragmented care was linked to lower rates of hospitalization for ACSCs. In integrated settings such as the VA, multiple providers, and dispersed care might offer access to timely or specialized care that offsets risks of fragmentation, particularly for conditions that are sensitive to ambulatory care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1475-6773.13956","type":"journal-article","created":{"date-parts":[[2022,2,18]],"date-time":"2022-02-18T09:23:01Z","timestamp":1645176181000},"page":"764-774","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Outpatient care fragmentation in Veterans Affairs patients at high\u2010risk for hospitalization"],"prefix":"10.1111","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8904-2810","authenticated-orcid":false,"given":"Donna M.","family":"Zulman","sequence":"first","affiliation":[{"name":"Center for Innovation to Implementation VA Palo Alto Health Care System  Menlo Park California USA"},{"name":"Department of Medicine Stanford 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