Practice makes perfect for elderly heart patients

Elderly patients treated for heart attack were 12% less likely to die if their treating physician was a cardiologist rather than a primary care physician, confirms a Duke University study.¹ The finding may not be overly surprising, but has implications in view of current strategies of managed care to limit access to specialists: Pay close attention to patient outcomes.

The study was the first to report that the type of physician treating patients with acute heart attack makes a difference. Of the 221,000 Medicare patients who suffered a heart attack in 1992, the 64% who were attended by primary care physicians had a lower chance of survival than the 34% under the care of cardiologists. A year later, 38% of patients treated by primary care physicians had died as compared to 30% who had seen the cardiologists.

While with saving more lives, cardiologists also cost the health care system more than primary care doctors, according to the study. Specialist-treated patients underwent more diagnostic and therapeutic procedures, had longer hospital stays, and received more medication.

^Reference

1. Jollis JG, DeLong ER, Peterson ED, et al. Outcome of acute myocardial infarction according to the specialty of the admitting physician. N Engl J Med 1996; 335:1,880-1,887.