Physician Age and Death in the Hospital

iStock-611776510Does your doctor's age affect whether you will die within 30 days of admission to a hospital? According to a study in the BMJ Rick and I discuss on PodMed this week, the answer is yes, if you're 65 or older. The numbers in this study are huge: over 730,000 Medicare admissions managed by almost 19,000 hospitalists across the country, which represented a 20% sample of such admissions between 2011 and 2014. The basic question was what was the 30-day mortality associated with the age of the physician? Besides hospitalists, the analysis also included data from general internists.

The study found that for physicians younger than 40, the 30 day mortality was 10.8%. For those 40-49, it was 11.1%, 11.3% for the 50-59 age range, and finally, for those 60 years of age or greater, was 12.1%. Older physicians also had slightly higher costs of care, and most interestingly, the difference disappeared when volume was factored in, with those seeing larger numbers of patients having the same rates.

Well. Rick speculates that perhaps there are cultural differences among older physicians, citing his own experience in practice as very much a solo flyer, perhaps without the benefit of team assessments and other support that might influence these figures, such as not accessing the evidence base when making decisions, and suggests strategies for assessing these possibilities. Another physician I know, also in the 60+ cohort, suggests that older physicians, by way of experience, may simply step out of the way when faced with a patient whose outcome looks as if no intervention would be beneficial, while younger physicians may be operating with the adage that 'when there's life there's hope.' Clearly, such a bias could also be assessed in further studies.

Other topics this week include another from the BMJ: Online abortion service is safe and effective way to end pregnancy, finds study, and two from Annals of Internal Medicine: Prevalence of Elevated Cardiovascular Risks in Young AdultsA Cross-sectional Analysis of National Health and Nutrition Examination Surveys, and Missed Opportunities for MMR Vaccination Among Departing U.S. Adult Travelers Receiving Pretravel Health Consultation. Until next week, y'all live well.

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