Patients Treated by International Medical Graduates Have Lower Death Rates

Although international graduates are required to pass examinations to practice medicine, concerns have been raised about the quality of care provided by them.

International medical graduates make up a quarter of the physician workforce in the United States, United Kingdom, Canada, and Australia. Although international graduates are required to pass examinations to practice medicine in the UK and US, concerns have been raised about the quality of care provided by these graduates.

Yet no study has investigated differences in patient outcomes between international medical graduates and US medical graduates using nationally representative data.

Researchers Identify Ways to Improve Quality of Care Measurement
Electronic reporting, although generally accurate, can both underestimate and overestimate quality.

‘In the United States, patient death rates are lower for internationally trained graduates than for graduates from a US medical school, despite international graduates caring for patients with higher rates of chronic conditions.’

So a team of researchers set out to determine whether patient outcomes differ between general internists who graduated from a medical school outside the US and those who graduated from a US medical school.

They analyzed a national sample of data for over 1.2 million Medicare beneficiaries aged 65 years or older admitted to hospital with a medical condition in 2011-14 and treated by over 44,000 international or US medical graduates who were general internists.

The primary outcome was 30 day mortality of patients. Secondary outcomes were 30 day readmission rates and costs of care.

Quality of Care in Nursing Homes Improved
A study from the Regenstrief Institute and the Indiana University Center for Aging Research has found that nursing home care improves in critical areas including falls, quality of life and rehospitalizations.

Compared with patients treated by US graduates, patients treated by international graduates had slightly more chronic conditions.

After adjusting for factors that could have affected the results (including patient characteristics, physician characteristics, and hospital fixed effects), they found that patients cared for by international graduates had a lower risk of mortality (11.2% v 11.6%) than patients cared for by US graduates across a broad range of clinical conditions.

Costs can be Reduced by Investing in Quality of Care for Diabetic Patients
Medical group practices can reduce costs for patients with diabetes by investing in improved quality of care, University of Minnesota School of Public Health researchers have found.

The researchers say that for every 250 patients treated by US medical graduates, one patient's life would be saved if the quality of care were equivalent between the international graduates and US graduates.

Readmission rates did not differ between the two types of graduates, whereas costs of care per admission was slightly higher for international medical graduates ($1145 v $1098). Further analysis to test the strength of the results made no difference to the overall findings

Researchers Recommended New Signal Functions to Improve Quality of Care for Newborns
Researchers at University of Heidelberg have recommended new signal functions that can improve the monitoring and tracking of facilities' provision of routine and emergency newborn care.

One possible explanation, say the authors, is that the current approach for allowing international medical graduates to practice in the US may select for, on average, better physicians.

They stress that this is an observational study so no firm conclusions can be drawn about cause and effect. Nevertheless, they say their findings "should reassure policymakers and the public that our current approach to licensing international medical graduates in the US is sufficiently rigorous to ensure high quality care."

Source-Eurekalert