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- Title
Comparison of Hospital Outcomes for Patients Treated by Allopathic Versus Osteopathic Hospitalists: An Observational Study.
- Authors
Miyawaki, Atsushi; Jena, Anupam B.; Gross, Nate; Tsugawa, Yusuke
- Abstract
The United States has 2 types of institutions that educate physicians: allopathic medical schools, which award MD degrees, and osteopathic medical schools, which award DO degrees. This study examined whether the quality and costs of care are similar for allopathic and osteopathic hospitalists who care for elderly patients. Visual Abstract. Comparison of Hospital Outcomes for Patients Treated by Allopathic Versus Osteopathic Hospitalists: The United States has 2 types of degree programs that educate physicians. Allopathic medical schools award MD degrees, and osteopathic medical schools award DO degrees. Although there are many reasons to believe that the 2 types of physicians provide equal care, there is too little information about this issue. This article describes a study that examined whether the quality and costs of care are similar for allopathic and osteopathic hospitalists who take care of elderly patients. Background: The United States has 2 types of degree programs that educate physicians: allopathic and osteopathic medical schools. Objective: To determine whether quality and costs of care differ between hospitalized Medicare patients treated by allopathic or osteopathic physicians. Design: Retrospective observational study. Setting: Medicare claims data. Patients: 20% random sample of Medicare fee-for-service beneficiaries hospitalized with a medical condition during 2016 to 2019 and treated by hospitalists. Measurements: The primary outcome was 30-day patient mortality. The secondary outcomes were 30-day readmission, length of stay (LOS), and health care spending (Part B spending). Multivariable regression models adjusted for patient and physician characteristics and their hospital-level averages (to effectively estimate differences within hospitals) were estimated. Results: Of 329 510 Medicare admissions, 253 670 (77.0%) and 75 840 (23.0%) received care from allopathic and osteopathic physicians, respectively. The results can rule out important differences in quality and costs of care between allopathic versus osteopathic physicians for patient mortality (adjusted mortality, 9.4% for allopathic physicians vs. 9.5% [reference] for osteopathic hospitalists; average marginal effect [AME], −0.1 percentage point [95% CI, −0.4 to 0.1 percentage point]; P = 0.36), readmission (15.7% vs. 15.6%; AME, 0.1 percentage point [CI, −0.4 to 0.3 percentage point; P = 0.72), LOS (4.5 vs. 4.5 days; adjusted difference, −0.001 day [CI, −0.04 to 0.04 day]; P = 0.96), and health care spending ($1004 vs. $1003; adjusted difference, $1 [CI, −$8 to $10]; P = 0.85). Limitation: Data were limited to elderly Medicare patients hospitalized with medical conditions. Conclusion: The quality and costs of care were similar between allopathic and osteopathic hospitalists when they cared for elderly patients and worked as the principal physician in a team of health care professionals that often included other allopathic and osteopathic physicians. Primary Funding Source: National Institutes of Health/National Institute on Aging.
- Subjects
UNITED States; OSTEOPATHIC physicians; MEDICAL personnel; HOSPITALISTS; MEDICARE; NATIONAL Institutes of Health (U.S.); HOSPITAL patients; HEALTH care teams; MEDICAL care costs
- Publication
Annals of Internal Medicine, 2023, Vol 176, Issue 6, p798
- ISSN
0003-4819
- Publication type
Article
- DOI
10.7326/M22-3723