Medicare patients more likely to die after seeing hospitalists than primary care physician, study finds

Medicare patients receiving treatment for common conditions such as pneumonia or heart failure are more likely to die within 30 days after seeing a hospitalist instead of their primary care physician in the hospital, according to a new study in JAMA Internal Medicine.

The study, led by Jennifer Stevens, MD, examined 560,651 admissions to acute care hospitals from January 1 through December 31, 2013, in all 50 states and Washington, D.C., as a random sample of continuously enrolled Medicare participants. They restricted admissions to the 20 most common diagnoses and then looked to see if patients saw a hospitalist or PCP during their stay.

The study found the length of stay for those cared for by PCPs was 12 percent longer than for those who saw hospitalists. However, they also found that the mortality rate within 30 days for those who saw their PCPs was just under 9 percent while the rate for those who saw hospitalists was nearly 11 percent.

"Our results suggest that longitudinal contact with a patient may translate into meaningful differences in care patterns and patient outcomes. Novel models of care that integrate PCPs who care for patients in the ambulatory setting with their patient's hospital care may yield substantial benefits in outcomes that are meaningful to patients," the study's authors write.  

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