Finding seen despite similar prior health status of patients and subsequent mortality rates
By Lori Solomon HealthDay Reporter
THURSDAY, Jan. 2, 2025 (HealthDay News) — Emergency department physicians show wide variability in their admission propensity, despite seeing patients with similar prior health status, according to a study published online Dec. 23 in JAMA Internal Medicine.
Stephen Coussens, Ph.D., and Dan P. Ly, M.D., Ph.D., from the David Geffen School of Medicine at UCLA in Los Angeles, examined whether variation in emergency department physicians’ admission propensities was associated with patients’ subsequent mortality rates for visits involving chest pain, shortness of breath, and abdominal pain. The analysis included nationwide Veterans Affairs electronic health record data (2011 through 2019) for 2,098 physicians treating 2.1 million patient visits across 105 emergency departments.
The researchers found that physicians’ adjusted admission rates varied greatly within the same emergency department (chest pain: 90th percentile of physicians, 56.6 percent admitted versus 10th percentile, 32.6 percent admitted), although there were no associations between these adjusted admission rates and patients’ prior health status as measured by their Elixhauser Comorbidity Index score before the emergency visit. Patients admitted by physicians with higher admission rates were more likely to be discharged within 24 hours (31.0 versus 24.8 percent). However, mortality rates for patients did not differ between physicians with higher admission rates and those with lower admission rates.
“Future research that explores how such variation arises and the extent to which it is amenable to safe intervention may prove beneficial to patients, clinicians, and health care systems,” the authors write.
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