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Potentially Avoidable Hospitalizations of Medicare Patients for Pneumonia and Chronic Obstructive Pulmonary Disease
Physician Experience Counts But Lack of Resources Contributes to High Hospitalization Rates
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But patients of physicians reporting more difficulty accessing ancillary services for patientsfor example, home oxygen or respiratory therapyand physicians treating more poor patients were at higher risk of hospitalization for both conditions, the study found.
Bacterial pneumonia and COPD are the third and fifth most common reasons for hospitalization among Medicare patients aged 65 and older, but some of the hospitalizations are avoidable with high-quality outpatient management.
"The study confirms what many physicians practicing in low-income areas intuitively knowthat a lack of resources hinders their ability to provide high-quality care and may increase the need for hospitalization," said Ann S. OMalley, M.D., M.P.H., the studys lead author and a senior health researcher at HSC, a nonpartisan policy research organization funded principally by the Robert Wood Johnson Foundation.
The article concludes "making additional clinical resources available to subgroups of physicians who have less access to ancillary services and a high proportion of Medicaid patients may help reduce their patients risk of hospitalization from COPD and bacterial pneumonia."
The study, "Potentially Avoidable Hospitalizations for COPD and Pneumonia: The Role of Physician and Practice Characteristics" is based on HSCs 2000-01 nationally representative Community Tracking Study Physician Survey, which collected information from 12,000 practicing physicians, and Medicare claims information on beneficiaries these physicians treated in 2000-02. Data on physicians and patients were linked with the use of the physicians unique provider identification number, and a total of 5,764 physicians and 509,613 elderly Medicare patients were included in the study.
Key study findings include:
The study was coauthored by Hoangmai H. Pham, M.D., M.P.H., of HSC; Deborah
Schrag, M.D., M.P.H., of MSKCC; Beny Wu, M.S., of Social Scientific Systems;
and Peter B. Bach, M.D., M.A.P.P., of MSKCC; and was supported by grants from
the National Cancer Institute, the National Institute on Aging and the Robert
Wood Johnson Foundation.
The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nations changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is funded principally by the Robert Wood Johnson Foundation and is affiliated with Mathematica Policy Research, Inc.
Memorial Sloan-Kettering Cancer Center is the worlds oldest and largest private institution devoted to prevention, patient care, research and education in cancer. MSKCC scientists and clinicians generate innovative approaches to better understand, diagnose and treat cancer. MSKCC specialists are leaders in biomedical research and in translating the latest research to advance the standard of cancer care worldwide. For more information, go to www.mskcc.org