Non US-trained physician yield lower patient mortality rates — 5 points

British Medical Journal published a study finding Medicare patients who obtained care from physicians who were trained outside the United States had lower 30-day mortality rates than those patients cared for by U.S.-trained physicians, according to Medscape.

Researchers evaluated 30-day mortality rate, readmission rate, treatment costs and whether clinical condition impacted differences in patient outcomes and care costs between patients treated by physicians with or without U.S. medical school training. Researchers analyzed 1,215,490 patients admitted to the hospital under the care of 44,227 general internists between 2011 and 2014

In the study, 44.3 percent of the internists obtained medical school training outside the United States. These providers were more likely to work in non-teaching, for profit, medium-sized hospitals lacking intensive care units. Their patients were more likely to be on Medicaid, be non-Caucasian, have lower median household income and have more chronic comorbidities.

Here are five points:

1. Those patients treated by non-U.S. medical school graduates had a mortality rate of 11.2 percent. Comparatively, patients treated by providers with U.S. training had an 11.6 mortality rate.

2. Based on these figures, the researchers stated, "Based on the risk difference of 0.4 percentage points, for every 250 patients treated by U.S. medical graduates, one patient's life would be saved if the quality of care were equivalent between the international graduates and U.S. graduates."

3. Patients of internationally trained internists had adjusted costs of care per admission totaling $1,145. Non U.S.-trained internists had $1,098 adjusted costs of care per admission.

4. The researchers did not note a difference in adjusted readmission rates.

5. The study authors noted a study limitation included not being able to assign patient outcomes to physicians from individual countries.

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