Higher Mortality Rates Linked To Less Experienced Hospital Care Specialists: Study

Individuals treated by doctors in their first year of practice at a particular hospital may face a greater risk of dying, when compared to those treated by doctors with more experience, according to the findings of new research. 

In a study published in the journal JAMA Internal Medicine December 26, researchers from the University of Texas confirm that there is a link between hospital experience and mortality rates. Hospitalists with the least experience had the highest mortality rates.

Researchers analyzed data from a 5% national sample of Medicare patient data, which included more than 100,000 hospitalizations, representing more than 2 million total hospitalizations of Medicare recipients. This included more than 21,000 hospitalists during two different time periods: July 1, 2008, to June 30, 2011, and July 1, 2013, and June 20, 2014.

The study honed in on hospitalists, which are internist doctors who work exclusively in a hospital setting. They focus on care for hospital patients.

Many hospitalists are new graduates of residency programs. They also tend to have more frequent turnover because they often switch to primary care medicine or begin fellowship training.

Similarly, some international medical graduates spend two years as hospitalists in underserved areas to meet a visa requirement before moving on to other training. Thus, many hospitalists often have the least experience.

Overall, researchers saw a “significant association” between hospitalist experience and mortality. Patient 30 day mortality was 10.5% for patients of first year hospitalists. Comparatively, 30 day mortality was 9.9% for patients of hospitalists in their second year of practice.

The study also noted that mortality odds were higher for patients of first year hospitalists. Mortality was 3.33% for patients of first year hospitalistsm and then drupped to 2.96% for second year hospitalists. The correlation indicated a decrease in death rates with more experience gained.

“Patients cared for by hospitalists in their first year of practice experience higher mortality,” the researchers determined. “Early-career hospitalists may require additional support to ensure optimal outcomes for their patients.”

Researchers noted that approximately 25% of hospitalists, or nearly 5,500 doctors, had only one year of experience or less. Comparatively, about 54% of hospitalists, or 11,500 doctors, had four years of experience or more.

Many other studies which focus on experience in relation to mortality use different experience categories, indicating the lowest experience category is 1 to 5 years. However, breaking down the experience categories to individual years offers more information concerning outcomes and experience, according to the researchers.