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.
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