Within the same hospital, elderly patients had higher death rates when they were treated by older physicians than when younger doctors cared for them, a recent study concludes.
With doctors under 40 years old, about 11 percent of patients died within 30 days of being admitted to the hospital, the study found. The death rates climbed as doctors got older, with average 30-day mortality of just over 12 percent among patients treated by physicians 60 and older.
"Our findings suggest that the impact of the latest medical knowledge and skills on patient outcomes may be larger than that of the experience accumulated by older doctors," lead study author Dr. Yusuke Tsugawa of the Harvard T.H. Chan School of Public Health said by email.
There was an exception, though. When doctors treated similarly high numbers of patients, there was no association between physicians' ages and patient mortality rates, researchers report in The BMJ.
For the study, researchers examined data on almost 737,000 adults 65 and older treated by physicians known as hospitalists who provide general medical care to patients admitted to the hospital.
All of the patients in the study were insured by Medicare, the U.S. health program for the elderly, and hospitalized for medical conditions between 2011 and 2014. The 18,854 physicians in the study were about 43 years old on average.
The youngest group of doctors in the study, the under-40 group, had typically finished their medical training about five years earlier. Among the oldest group of doctors, 60 and up, an average of almost three decades had passed since they finished their training.
Physician age didn't appear to influence the odds of what's known as readmissions, or patients who return to the hospital within 30 days of being sent home, the study found.
For doctors who treated a low or medium volume of patients, each 10-year increase in physician age was, however, associated with 19 percent higher odds that patients would die within 30 days of being admitted to the hospital.
For all of the doctors, each 10-year increase in physician age was also linked to a 2.4 percent increase in Medicare spending on patient care, the study also found.
The study wasn't a controlled experiment designed to prove that physician age is directly responsible for differences in death rates or health costs.
One limitation of the study is the potential for factors other than physician age to influence mortality rates, the authors note. For example, if patients at higher risk of death were more often assigned to older physicians, that would confound the results.
The study also doesn't show how death rates might vary over the course of an individual physician's career, senior study author Dr. Anupam Jena of Harvard Medical School in Boston said by email.
Patients shouldn't choose a doctor based on age alone, noted Linda Aiken, director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing.
"Younger doctors have more recent education but experienced doctors have a wealth of knowledge that may be very important in helping with your particular health challenges," Aiken, author of an accompanying editorial, said by email.
"If you have a serious, life-threatening illness likely to involve hospital care, think about consulting a specialist and identifying a great hospital," Aiken added. "Patients have no choice about which hospitalists will be caring for them but they can choose their hospital."
SOURCE: bit.ly/2qRe1WS and bit.ly/2qdxJXN The BMJ, online May 16, 2017.