CHICAGO — 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.
Also, among hospitalist patients, 36
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
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
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.
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