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US-trained docs have higher patient death rate

Doctor and patient
Photo courtesy of the CDC

A large study has revealed a lower death rate among US patients treated by internationally trained doctors rather than US-trained doctors.

Researchers

analyzed data on more than 1.2 million US hospital admissions and found

a slight but statistically significant difference in 30-day mortality

for patients treated by internationally trained doctors and US-trained

doctors—11.2% and

11.6%, respectively (P<0.001).

These findings were published in The BMJ.

Yusuke Tsugawa, MD, PhD, of Harvard T H Chan School of Public Health in Boston, Massachusetts, and his colleagues conducted this research.

The team wanted to determine whether patient outcomes differ between general internists who graduated from a medical school outside the US and those who graduated from a US medical school.

The researchers analyzed data on the treatment of Medicare beneficiaries (age 65 and older) who were admitted to a hospital with a medical condition from 2011 through 2014. This included 1,215,490 hospital admissions and 44,227 general internists.

The primary outcome was 30-day patient mortality. Secondary outcomes were 30-day readmission rates and costs of care.

Compared with patients treated by US graduates, patients treated by international graduates had slightly more chronic conditions.

After adjusting for factors that could have affected the results (including patient characteristics, physician characteristics, and hospital fixed effects), the researchers found that patients cared for by international graduates had a lower rate of 30-day mortality than patients cared for by US graduates (11.2% and

11.6%, respectively, P<0.001).

The researchers said that for every 250 patients treated by US medical graduates, 1 patient’s life would be saved if the quality of care were equivalent between the international graduates and US graduates.

Thirty-day readmission rates did not differ significantly between the 2 types of graduates—15.4% for international graduates and 15.5% for US graduates (P=0.54).

However, the cost of care per admission was higher for international medical graduates—$1145 vs $1098 (P<0.001).

Further analysis to test the strength of these results made no difference to the overall findings.

One possible explanation for these findings, according to the researchers, is that the current approach for allowing international medical graduates to practice in the US may select for, on average, better physicians.

The team stressed that this is an observational study, so no firm conclusions can be drawn about cause and effect. Nevertheless, they said their findings “should reassure policymakers and the public that our current approach to licensing international medical graduates in the US is sufficiently rigorous to ensure high quality care.”

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Doctor and patient
Photo courtesy of the CDC

A large study has revealed a lower death rate among US patients treated by internationally trained doctors rather than US-trained doctors.

Researchers

analyzed data on more than 1.2 million US hospital admissions and found

a slight but statistically significant difference in 30-day mortality

for patients treated by internationally trained doctors and US-trained

doctors—11.2% and

11.6%, respectively (P<0.001).

These findings were published in The BMJ.

Yusuke Tsugawa, MD, PhD, of Harvard T H Chan School of Public Health in Boston, Massachusetts, and his colleagues conducted this research.

The team wanted to determine whether patient outcomes differ between general internists who graduated from a medical school outside the US and those who graduated from a US medical school.

The researchers analyzed data on the treatment of Medicare beneficiaries (age 65 and older) who were admitted to a hospital with a medical condition from 2011 through 2014. This included 1,215,490 hospital admissions and 44,227 general internists.

The primary outcome was 30-day patient mortality. Secondary outcomes were 30-day readmission rates and costs of care.

Compared with patients treated by US graduates, patients treated by international graduates had slightly more chronic conditions.

After adjusting for factors that could have affected the results (including patient characteristics, physician characteristics, and hospital fixed effects), the researchers found that patients cared for by international graduates had a lower rate of 30-day mortality than patients cared for by US graduates (11.2% and

11.6%, respectively, P<0.001).

The researchers said that for every 250 patients treated by US medical graduates, 1 patient’s life would be saved if the quality of care were equivalent between the international graduates and US graduates.

Thirty-day readmission rates did not differ significantly between the 2 types of graduates—15.4% for international graduates and 15.5% for US graduates (P=0.54).

However, the cost of care per admission was higher for international medical graduates—$1145 vs $1098 (P<0.001).

Further analysis to test the strength of these results made no difference to the overall findings.

One possible explanation for these findings, according to the researchers, is that the current approach for allowing international medical graduates to practice in the US may select for, on average, better physicians.

The team stressed that this is an observational study, so no firm conclusions can be drawn about cause and effect. Nevertheless, they said their findings “should reassure policymakers and the public that our current approach to licensing international medical graduates in the US is sufficiently rigorous to ensure high quality care.”

Doctor and patient
Photo courtesy of the CDC

A large study has revealed a lower death rate among US patients treated by internationally trained doctors rather than US-trained doctors.

Researchers

analyzed data on more than 1.2 million US hospital admissions and found

a slight but statistically significant difference in 30-day mortality

for patients treated by internationally trained doctors and US-trained

doctors—11.2% and

11.6%, respectively (P<0.001).

These findings were published in The BMJ.

Yusuke Tsugawa, MD, PhD, of Harvard T H Chan School of Public Health in Boston, Massachusetts, and his colleagues conducted this research.

The team wanted to determine whether patient outcomes differ between general internists who graduated from a medical school outside the US and those who graduated from a US medical school.

The researchers analyzed data on the treatment of Medicare beneficiaries (age 65 and older) who were admitted to a hospital with a medical condition from 2011 through 2014. This included 1,215,490 hospital admissions and 44,227 general internists.

The primary outcome was 30-day patient mortality. Secondary outcomes were 30-day readmission rates and costs of care.

Compared with patients treated by US graduates, patients treated by international graduates had slightly more chronic conditions.

After adjusting for factors that could have affected the results (including patient characteristics, physician characteristics, and hospital fixed effects), the researchers found that patients cared for by international graduates had a lower rate of 30-day mortality than patients cared for by US graduates (11.2% and

11.6%, respectively, P<0.001).

The researchers said that for every 250 patients treated by US medical graduates, 1 patient’s life would be saved if the quality of care were equivalent between the international graduates and US graduates.

Thirty-day readmission rates did not differ significantly between the 2 types of graduates—15.4% for international graduates and 15.5% for US graduates (P=0.54).

However, the cost of care per admission was higher for international medical graduates—$1145 vs $1098 (P<0.001).

Further analysis to test the strength of these results made no difference to the overall findings.

One possible explanation for these findings, according to the researchers, is that the current approach for allowing international medical graduates to practice in the US may select for, on average, better physicians.

The team stressed that this is an observational study, so no firm conclusions can be drawn about cause and effect. Nevertheless, they said their findings “should reassure policymakers and the public that our current approach to licensing international medical graduates in the US is sufficiently rigorous to ensure high quality care.”

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