partlycloudy
Tuesday November 21st, 2017 8:54AM

Is your own MD best in the hospital? Study eyes hospitalists

By The Associated Press
Related Articles
  Contact Editor

CHICAGO (AP) — The old-fashioned, family doctor style of medicine could be lifesaving for elderly hospitalized patients, a big study suggests, showing benefits over a rapidly expanding alternative that has hospital-based doctors overseeing care instead.

Medicare patients with common conditions including pneumonia, heart failure and urinary infections who were treated by their own primary care doctors were slightly more likely to survive after being sent home than those cared for instead by hospitalists — internists who provide care only in hospitals.

While hospitalist care can shorten stays and reduce costs, the new results suggest that, for at least some patients, getting taken care of in the hospital by a doctor who knows them can have important advantages.

Almost 11 percent of patients cared for by a hospitalist died within 30 days of leaving the hospital, compared with just under 9 percent of primary care patients. While that difference was small, it "was certainly a startling finding," said Dr. Jennifer Stevens, the study's lead author at Harvard Medical School.

Also, among hospitalist patients, 36 percent were sent to a nursing home or other long-term care center, versus about 30 percent of primary care patients. Studies show that elderly patients who are discharged to nursing homes are less likely than others to ever return to their homes, Stevens said.

Reasons for those advantages are unclear. Stevens noted that primary care doctors who know their patients' health and family histories may be more attuned to how well they can manage at home after hospitalization and which potentially risky follow-up tests or medicines they can avoid.

Stevens and her colleagues analyzed Medicare claims data on nearly 600,000 hospital admissions in 2013. Their results were published Monday in JAMA Internal Medicine.

The researchers don't advocate replacing hospitalists, but Stevens said the study "opens the door" to limiting their use with certain hospital patients, particularly the elderly. Patients in the study were aged 80 on average.

The hospitalist specialty has grown since the 1990s amid insurance industry changes, rising demands on primary care doctors' time and research showing hospitalists can shorten patients' stays and reduce costs. In 1995, hospitalists provided 9 percent of general medicine services in hospitals, but by 2013 that had grown to nearly 60 percent, a journal editorial noted.

Hospitalists may bring "new eyes" to patients' problems, but the study results, if valid, suggest there's a trade-off, the editorial said.

In the study, 60 percent of patients got their hospital care from hospitalists versus only 14 percent from their primary care doctors. The rest got care from other general physicians including partners of patients' primary physicians. These were physicians who likely didn't know the patients or the hospital well, Stevens said.

The average length of stay was about 5 days for primary care or general care and about half a day shorter for hospitalists.

Those treated by other general physicians were slightly more likely than the others to die within 30 days of discharge and to be readmitted to the hospital.

___

Follow Medical writer Lindsey Tanner on Twitter at @LindseyTanner . Her work can be found here.

  • Associated Categories: U.S. News, Associated Press (AP), AP National News, Top U.S. News short headlines, AP Health, AP Health - Senior Health
© Copyright 2017 AccessWDUN.com
All rights reserved. This material may not be published, broadcast, rewritten, or redistributed without permission.
Is your own MD best in the hospital? Study eyes hospitalists
Study suggest old-fashioned family doctor style of medicine could be lifesaving for elderly hospital patients
12:45PM ( 4 minutes ago )
Lebanese cardinal arrives in Saudi Arabia to meet Hariri
The head of the Maronite Catholic community in Lebanon says that the return of Prime Minister Saad Hariri from the kingdom back home will bring back normal life to the country
12:44PM ( 5 minutes ago )
Sudan's president, wanted by the ICC, visits Uganda
Sudan's president, who is wanted by the International Criminal Court, arrived in Uganda Monday on a two-day official visit
12:32PM ( 17 minutes ago )
Associated Press (AP)
Top GOP leader on allegations on Moore: I believe the women
The top Republican in the Senate says GOP candidate Roy Moore should quit the Alabama race
12:01PM ( 48 minutes ago )
The Latest: McConnell says Roy Moore should step aside
Senate Majority Leader Mitch McConnell says that Republican Senate candidate Roy Moore of Alabama "should step aside" in light of allegations he had sexual contact with a 14-year-old girl decades ago
11:56AM ( 53 minutes ago )
Colin Kaepernick named GQ magazine's citizen of the year
Free agent quarterback Colin Kaepernick has been named GQ's magazine's "Citizen of the Year" for his activism
11:35AM ( 1 hour ago )
AP National News
Study suggests women less likely to get CPR from bystanders
A new study suggests that women are less likely than men to get CPR from a bystander and are more likely to die
3:14PM ( 21 hours ago )
Schwarzenegger calls on climate activists to change methods
Movie star and former California governor Arnold Schwarzenegger wants environmental activists to give more attention to immediate health hazards like air and water pollution
11:58AM ( 1 day ago )
US cities, states defy Trump, still back Paris climate deal
A group of U.S. states, cities, businesses and universities say they are committed to curbing global warming even as the Trump administration is walking away from the Paris climate accord
7:30PM ( 1 day ago )
AP Health
Repeal of medical deduction prompts tax bill pushback
Groups representing older people and patients push back on repeal of medical deduction
1:23PM ( 5 days ago )
Threatened medical deduction seen as valuable, versatile
Groups representing older people and patients push back on repeal of medical deduction
3:41AM ( 6 days ago )
Democrats slam GOP budget on taxes, health care cuts
The Republican-led Senate rejected Democratic attempts to spare health programs for the poor and elderly from cuts, absorbing political hits as the price for advancing a budget plan that's a crucial step in the GOP's drive to rewrite the tax code
5:12PM ( 3 weeks ago )
AP Health - Senior Health
Lebanese cardinal arrives in Saudi Arabia to meet Hariri
The head of the Maronite Catholic community in Lebanon says that the return of Prime Minister Saad Hariri from the kingdom back home will bring back normal life to the country
12:44PM ( 5 minutes ago )
Sudan's president, wanted by the ICC, visits Uganda
Sudan's president, who is wanted by the International Criminal Court, arrived in Uganda Monday on a two-day official visit
12:32PM ( 17 minutes ago )
Sen. Rand Paul returns to Washington following assault
Sen. Rand Paul is returning to Washington following an attack in his yard that left him with six broken ribs
12:22PM ( 27 minutes ago )
Trump barges into tax debate, seeks deeper cut for wealthy
President Donald Trump barged into congressional Republicans carefully calibrated work on revamping the nation's tax code, calling for a steeper tax cut for wealthy Americans and pressing to add a contentious health care change to the mix
12:19PM ( 30 minutes ago )
LeBron: Smith comments a shot at Phil Jackson, not Ntilikina
LeBron James says his belief that the Knicks should have drafted Dennis Smith Jr. wasn't meant to slight Frank Ntilikina, though was intended as a swipe at Phil Jackson
12:19PM ( 30 minutes ago )