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Am J Med. 2011 Sep;124(9):868-74. doi: 10.1016/j.amjmed.2011.04.011. Epub 2011 Jul 23.

Longer lengths of stay and higher risk of mortality among inpatients of physicians with more years in practice.

Author information

  • 1Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY 10467, USA. wsouther@montefiore.org

Abstract

BACKGROUND:

More physician years in practice have been associated with less frequent guideline adherence, but it is unknown whether years in practice are associated with patient outcomes.

METHODS:

We examined all inpatients on the teaching service of an urban hospital from July 1, 2002 through June 30, 2004. Admissions were assigned to attending physicians quasi-randomly. Years in practice was defined as the number of years the attending physician held a medical license. We divided physicians into 4 groups (0-5, 6-10, 11-20, and >20 years in practice), and used negative binomial and logistic regression to adjust for patient characteristics and estimate associations between years in practice and length-of-stay, readmission, and mortality.

RESULTS:

Fifty-nine physicians and 6572 admissions were examined. Although the 4 inpatient groups had similar demographic and clinical characteristics, physicians with more years in practice had longer mean lengths of stay (4.77, 5.29, 5.42, and 5.31 days for physicians with 0-5, 6-10, 11-20, and >20 years in practice, respectively, P=.001). After adjustment, inpatients of physicians with more than 20 years in practice had higher risk for both in-hospital mortality (odds ratio 1.71; 95% confidence interval, 1.06-2.76) and 30-day mortality (odds ratio 1.51, 95% confidence interval, 1.06-2.16) than inpatients of physicians with 0-5 years in practice.

CONCLUSION:

Inpatient care by physicians with more years in practice is associated with higher risk of mortality. Quality-of-care interventions should be developed to maintain inpatient skills for physicians.

Copyright © 2011 Elsevier Inc. All rights reserved.

Comment in

PMID:
21745651
[PubMed - indexed for MEDLINE]
PMCID:
PMC3159750
Free PMC Article

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