MedicalResearch.com Interview with:
Yusuke Tsugawa, MD, MPH, PhD
Research Associate at Department of Health Policy and Management
Harvard T.H. Chan School of Public Health
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Prior evidence has been mixed as to whether or not patient outcomes
differ between U.S. and foreign medical graduates.
However, previous studies used small sample sizes or data from a small number of states.
Therefore, it was largely unknown how international medical graduates
perform compared with US medical graduates.
To answer this question, we analyzed a nationally representative
sample of Medicare beneficiaries admitted to hospitals with a medical
condition in 2011-2014. Our sample included approximately 1.2 million
hospitalizations treated by 40,000 physicians. After adjusting for
severity of illness of patients and hospitals (we compared physicians
within the same hospital), we found that patient treated by
international medical graduates had lower mortality than patients
cared for by US medical graduates (adjusted 30-day mortality rate
11.2% vs 11.6%, p<0.001). We observed no difference in readmissions,
whereas costs of care was slightly higher for international medical
MedicalResearch.com: What should readers take away from your report?
Response: One thing that is clear from our study is that foreign-trained doctors
are providing good quality of care for patients. This suggests that
selection method for incoming foreign medical graduates is successful
at identifying good quality doctors. Both of these points should be
reassuring news for patients and should help alleviate any stereotypes
about the quality of care provided of foreign-trained doctors.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Further studies are warranted to understand exactly why international
medical graduates may have better outcomes.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Quality of care delivered by general internists in US hospitals who
graduated from foreign versus US medical schools: observational stu
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