Patients treated by older physicians die more than patients cared for by younger ones, except those docs treating high volumes of patients

BMJ. 2017 May 16;357:j1797. doi: 10.1136/bmj.j1797.

Physician age and outcomes in elderly patients in hospital in the US: observational study.

Tsugawa Y, Newhouse JP, Zaslavsky AM, Blumenthal DM, Jena AB.

https://doi.org/10.1136/bmj.j1797

Abstract
Objectives To investigate whether outcomes of patients who were admitted to hospital differ between those treated by younger and older physicians.
Design: Observational study.
Setting: US acute care hospitals.

Participants: 20% random sample of Medicare fee-for-service beneficiaries aged ≥65 admitted to hospital with a medical condition in 2011-14 and treated by hospitalist physicians to whom they were assigned based on scheduled work shifts. To assess the generalizability of findings, analyses also included patients treated by general internists including both hospitalists and non-hospitalists.
Main outcome measures 30 day mortality and readmissions and costs of care.

Results: 736 537 admissions managed by 18 854 hospitalist physicians (median age 41) were included. Patients’ characteristics were similar across physician ages. After adjustment for characteristics of patients and physicians and hospital fixed effects (effectively comparing physicians within the same hospital), patients’ adjusted 30 day mortality rates were 10.8% for physicians aged <40 10.7="" 10.9="" 11.1="" 11.3="" 11.5="" 12.1="" 12.5="" 40-49="" 40="" 50-59="" a="" age="" aged="" among="" analyses.="" and="" association="" between="" br="" care="" confidence="" costs="" did="" for="" general="" high="" higher="" however="" in="" internists="" interval="" mortality.="" no="" not="" observed="" of="" older="" patient="" patients="" patterns="" physician="" physicians.="" physicians="" readmissions="" sensitivity="" several="" similar="" slightly="" there="" to="" vary="" volume="" was="" were="" while="" with=""> 

<40 10.7="" 10.9="" 11.1="" 11.3="" 11.5="" 12.1="" 12.5="" 40-49="" 50-59="" a="" age="" aged="" among="" analyses.="" and="" association="" between="" br="" care="" confidence="" costs="" did="" for="" general="" high="" higher="" however="" in="" internists="" interval="" mortality.="" no="" not="" observed="" of="" older="" patient="" patients="" patterns="" physician="" physicians.="" physicians="" readmissions="" sensitivity="" several="" similar="" slightly="" there="" to="" vary="" volume="" was="" were="" while="" with="">Conclusions: Within the same hospital, patients treated by older physicians had higher mortality than patients cared for by younger physicians, except those physicians treating high volumes of patients.