{"id":27080,"date":"2025-02-20T04:12:00","date_gmt":"2025-02-19T20:12:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=27080"},"modified":"2025-02-20T05:47:39","modified_gmt":"2025-02-19T21:47:39","slug":"jama-surg%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e4%bc%a0%e7%bb%9f%e5%8c%bb%e5%ad%a6%e4%b8%8e%e6%95%b4%e9%aa%a8%e5%8c%bb%e5%ad%a6%e5%a4%96%e7%a7%91%e5%8c%bb%e7%94%9f%e6%b2%bb%e7%96%97%e6%82%a3","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=27080","title":{"rendered":"[JAMA Surg\u53d1\u8868\u8bba\u6587]\uff1a\u4f20\u7edf\u533b\u5b66\u4e0e\u6574\u9aa8\u533b\u5b66\u5916\u79d1\u533b\u751f\u6cbb\u7597\u60a3\u8005\u9884\u540e\u6bd4\u8f83"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

October 16, 2024<\/p>\n\n\n\n

Comparison of Outcomes for Patients Treated by Allopathic vs Osteopathic Surgeons<\/h1>\n\n\n\n

Tara A. Russell, Ryu Yoshida, Mauranda Men, et al<\/h3>\n\n\n\n

JAMA Surg. <\/em>Published online October 16, 2024<\/h3>\n\n\n\n

doi:10.1001\/jamasurg.2024.4580<\/h3>\n\n\n\n

<\/a>Key Points<\/p>\n\n\n\n

Question<\/strong>  Is there is a difference in surgical outcomes for patients undergoing surgery with physicians trained in allopathic (MD) vs osteopathic (DO) medical schools?<\/p>\n\n\n\n

Finding<\/strong>  In this cohort study of Medicare beneficiaries from 2016 to 2019, there were no statistically significant differences in 30-day mortality, readmissions, or length of stay between patients who underwent common surgical operations with MD vs DO surgeons.<\/p>\n\n\n\n

Meaning<\/strong>  MDs and DOs achieve similar clinical outcomes, a fact that highlights the competency and expertise of both degree types in surgical care.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  There are 2 degree programs for licensed physicians in the US: allopathic medical doctorate (MD) and osteopathic doctorate (DO). However, evidence is limited as to whether outcomes differ between patients treated by MD vs DO surgeons.<\/p>\n\n\n\n

Objective<\/strong>  To evaluate differences in surgical outcomes and practice patterns by surgeon medical school training (MD vs DO).<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  This retrospective cohort study used 100% Medicare claims data from inpatient hospitals providing surgical services from January 1, 2016, to December 31, 2019 among Medicare fee-for-service beneficiaries aged 65 to 99 years who underwent 1 of the 14 most common surgical procedures. Data analysis was performed from January 17, 2023, to August 13, 2024.<\/p>\n\n\n\n

Exposure<\/strong>  Medical school degree (MD vs DO).<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  The primary outcome was 30-day mortality, and the secondary outcomes were readmissions and length of stay. To assess differences between surgeons by medical school training, a multivariable linear probability model was used, which was adjusted for hospital fixed effects and patient, procedure, and surgeon characteristics.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0Of the 2\u202f360\u202f108 total surgical procedures analyzed, 2\u202f154\u202f562 (91.3%) were performed by MD surgeons, and 205\u202f546 (8.7%) were performed by DO surgeons. Of 43\u202f651 total surgeons, most surgeons were MDs (39\u202f339 [90.1%]), the median (SD) age was 49.0 (9.8) years, and 6649 surgeons (15.2%) were female. The mean (SD) age of patients undergoing surgical procedures was 74.9 (6.7) years, 1\u202f353\u202f818 of 2\u202f360\u202f108 patients (57.4%) were female, and 2\u202f110\u202f611 patients (89.4%) self-reported as White. DO surgeons were significantly more likely to operate on older patients (DO patient mean [SD] age: 75.3 [7.1] years; MD patient mean [SD] age: 74.8 [6.6]), female patients (DO: 60.2% of patients; MD: 57.1% of patients), and Medicaid dual-eligible patients (DO: 10.3% of patients; MD: 8.6% of patients). DOs performed a lower proportion of elective operations (DO: 74.2% vs MD: 80.2%) and were more likely to work in public hospitals (DO: 10.3%; MD: 9.5%) and nonteaching hospitals (DO: 57.9%; MD: 68.1%). There was no evidence that 30-day mortality differed between MD and DO surgeons (adjusted mortality rate, DO: 1.61%; MD: 1.58%; absolute risk difference [aRD], \u22120.04 percentage points; 95% CI, \u22120.11 to 0.04;\u00a0P<\/em>\u2009=\u2009.37). On secondary analyses, no difference was found in 30-day readmissions or length of stay between MD and DO surgeons.<\/p>\n\n\n\n

\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n

Conclusions and Relevance<\/strong>  In this retrospective cohort study using Medicare data, there was no evidence that patient outcomes differed between MD and DO surgeons for common operations after adjusting for patient factors and practice settings.<\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  October 16, 2024 […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/27080"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=27080"}],"version-history":[{"count":3,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/27080\/revisions"}],"predecessor-version":[{"id":27717,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/27080\/revisions\/27717"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=27080"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=27080"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=27080"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}