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Patients die more often with older doctors

18 May 2017

Patients treated by older hospital-based internists known as hospitalists are somewhat more likely to die within a month of admission than those treated by younger physicians, according to the results of a study led by researchers at Harvard Medical School and Harvard T.H. Chan School of Public Health. A 2014 census of registered physicians found that 26.3 percent of doctors in the USA are 60 years or older, with nine percent of those over 70 - the study's data graph ends at 70 years old and has a mortality rate slightly below 13.5 percent.

Harvard researchers looked over data on more than 700,000 hospital admissions of elderly patients cared for by almost 19,000 physicians between 2011 and 2014.

A team of researchers led by Yusuke Tsugawa of Harvard University, in Boston, set out to measure the relationship between patient mortality and doctor age by crunching the numbers on 736,537 elderly United States hospital patients and the 18,854 doctors who treated them.

Among patients treated by hospital physicians under the age of 40, 10.8% died; for doctors aged 40 to 49, the figure was 11.1%; for doctors aged 50 to 59, it was 11.3%; and for doctors aged 60 or more, 12.1%.

There was an exception: for older doctors who were treating high volumes of patients, age did not translate to higher mortality in patients, according to the study published in The BMJ.

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But Tsugawa and his team found that among doctors who treat a large number of patients - an average of 200 per year - there was no difference between older and younger.

Researchers surveyed over 700,000 American hospital patients who received Medicare between 2011 and 2014 and nearly 19,000 doctors were involved in the study.

A new study looks at older and younger doctors' patient mortality rates. That allows for a degree of randomization of patients to doctors of varying age, which allows us to better elucidate what is the potential impact of a doctor's age on patient outcomes.

The researchers caution that their study is strictly observational, showing only a link, rather than cause and effect, between physician age and patient outcomes. Patient readmission rates were not affected by physician age, but cost of care was slightly higher among older physicians.

It may be time to re-think your bias against younger doctors. Additionally, the analysis focused on one subspecialty-hospitalists-and the findings may not apply to other specialists.

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"Older physicians bring invaluable richness of knowledge and depth of experience, yet their clinical skills may begin to lag behind over time", Jena said. Also, patients handled by a male doctor were 5% more likely to go back to the hospital. The thought is that newer physicians are in a sense exposed to many more cases when starting their career, while other physicians who have been practicing for many years may start to let their clinical skill decline. "Therefore, they may be more up-to-date when they start providing care", he said.

Researchers also said it's important that physicians participate in continuing medical education courses throughout their careers to improve patient outcomes.

Co-authors included Joseph Newhouse and Alan Zaslavsky, of Harvard Medical School, and Daniel Blumenthal, of Massachusetts General Hospital.

When it comes to medical care, does older equal wiser - and better?

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Patients die more often with older doctors