Dose Physician Age Impact Patient Outcomes?


The results of the Harvard University research found that for every 77 patients treated by a 60-plus medic, one fewer patient would die within 30 days had those same patients been cared for by a doctor aged less than 40. The researchers found that physicians who treated low to medium volumes of patients from 2011 to 2014 were the ones who primarily drove the link between physician age and patient mortality.

They analysed 30 day mortality, readmissions and costs of care for a random sample of 736,537 elderly Medicare patients (aged 65 or over) managed by 18,854 hospital physicians (average age 41) at United States acute care hospitals from 2011 to 2014.

Jena: Two reasons. First, we are broadly interested in understanding how care provided by individual physicians influences patient outcomes, and the particular understanding of how individual physician characteristics such as sex, where the physician trained, and their age relate to patient outcomes and cost of care.

To test whether physicians with high volumes of patients might better maintain clinical knowledge and skills, the team also analysed whether the association between physician age and patient mortality was altered by the number of patients each doctor treated. They found that mortality rates crept up in step with physician age. "Our findings suggest that the latter factor may have a larger impact on patient outcomes than the former".

The researchers stress that this study is purely observational and that it doesn't prove a cause and effect relationship between physician age and patient outcomes. The share of physicians aged 55 or over is within the range of 40-46 percent in Bulgaria, Cyprus, Germany, Hungary, Belgium, Latvia, Estonia and France, peaking at 52 percent in Italy. Researchers only considered elderly Medicare patients and doctors in the U.S.

The age of a physician may increase a patient's risk of dying in the hospital, according to a new study from Harvard Medical School.

Professor Anupam Jena, the co-author, explained, "Older physicians bring invaluable richness of knowledge and depth of experience, yet their clinical skills may begin to lag behind over time".

Readmissions did not vary with physician age, while costs of care were slightly higher among older physicians.

Hospital medicine is among the most rapidly evolving specialties within medicine, with dramatic changes in the training of recent cohorts of physicians who now work as hospitalists, including greater emphasis on multi-professional team based practice, adherence to clinical guidelines, training on patient handoffs, familiarity with shift work during residency training, and an improved hospital safety culture. Older doctors may be more likely to rely on anecdotal rather than evidence-based practices.

The findings "suggest that continuing medical education of physicians could be important and that continual assessment of outcomes might be useful", the study says.