1st-year hospitalists' patients have higher mortality rates than more experienced counterparts

A study, published in JAMA Internal Medicine, examined if patient mortality varies by years of prior experience hospitalists providing their care have.

Researchers used a 5 percent sample of national Medicare data comprising patient and hospital characteristics to build a multilevel logistic regression model. They established a cohort of 21,612 hospitalists working between July 1, 2013, and June 30, 2014, with a look-back period of five years to assess their prior experience as a hospitalist. Among these hospitalists, 25 percent had one year or less of experience, while 54 percent had four years of experience or more.

Researchers also established another cohort of 3,860 hospitalists in their first year of practice between July 1, 2008, and June 30, 2011, who then continued to practice for the next four years at least.

The study shows a significant association between hospitalist experience and mortality. Researchers found:

● Observed 30-day mortality was 10.50 percent for patients of first-year hospitalists as compared to 9.97 percent for patients of hospitalists in their second year
● The mortality odds for patients of second-year hospitalists were 0.90 compared with patients of first-year hospitalists
● Observed hospital mortality was 3.33 percent for patients cared for by first-year hospitalists versus 2.96 percent for second-year hospitalists' patients
● For both 30-day and hospital mortality rates, there was little change in mortality odds between the hospitalists in their second year and subsequent years

"Early-career hospitalists may require additional support to ensure optimal outcomes for their patients," study authors concluded.

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