ArticleMedical care2016
Mortality Among Older Adults Before Versus After Hospital Transition to Intensivist Staffing.
Article in Medical care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT07729891 (Real-time Evaluation and Continuous Observation of Vital Signs for Enhanced Recovery), which is not on this map. Cited by 10 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Real-time Evaluation and Continuous Observation of Vital Signs for Enhanced Recovery
Who cites it
10 citing papers in PubMed.
- Wearable devices as part of postoperative early warning score systems: a scoping review.Journal of clinical monitoring and computing · 2025Article
- Shift-Level Team Familiarity Is Associated with Improved Outcomes in Mechanically Ventilated Adults.American journal of respiratory and critical care medicine · 2024Article
- Clinical impact of physician staffing transition in intensive care units: a retrospective observational study.BMC anesthesiology · 2022Observational
- The Society of Critical Care Medicine at 50 Years: ICU Organization and Management.Critical care medicine · 2021Article
- [Internal hospital emergency management : Concepts for optimization of patient safety in hospitals].Der Anaesthesist · 2020Review
- Association Between Hospital Staffing Models and Failure to Rescue.Annals of surgery · 2019Observational
- Variation in Surgical Outcomes Across Networks of the Highest-Rated US Hospitals.JAMA surgery · 2019Article
- Interpersonal And Organizational Dynamics Are Key Drivers Of Failure To Rescue.Health affairs (Project Hope) · 2018Article
- Evidence supports the superiority of closed ICUs for patients and families: No.Intensive care medicine · 2017Article
- The authors reply.Critical care medicine · 2016Article
Corrections and comments
- Erratum issued
Authors and funding
5 authors.
Funding
Abstract
backgroundA large body of research suggests that hospitals with intensive care units staffed by board-certified intensivists have lower mortality rates than those that do not.
objectiveTo determine whether hospitals can reduce their mortality by adopting an intensivist staffing model.
designRetrospective, longitudinal study using 2003-2010 Medicare data and the Leapfrog Group Hospital surveys. SETTING AND PATIENTS: In total, 2,916,801 Medicare patients at 488 US hospitals. MEASUREMENTS: We studied 30-day and in-hospital mortality among patients with several common medical and surgical conditions. We first compared risk-adjusted mortality rates of 3 groups of hospitals: those that were intensivist staffed throughout this time period, those that were not intensivist staffed, and those that transitioned to intensivist staffing somewhere during the period. We then examined rates of mortality improvement within each of the 3 groups and used difference-in-differences techniques to assess the independent effect of intensivist staffing among the subset of hospitals that transitioned.
resultsHospitals with intensivist staffing at the beginning of our study period had lower mortality rates than those without. However, hospitals that adopted intensivist staffing during the study period did not substantially improve their mortality rates. In our difference-in-differences analysis, there was no significant independent improvement in mortality after transitioning to intensivist staffing either overall [relative risk (RR), 0.96; 95% confidence interval (CI), 0.90-1.02] or in the medical (RR, 0.95; 95% CI, 0.89-1.02) or surgical populations (RR, 0.97; 95% CI, 0.84-1.10). LIMITATIONS: Risk adjustment was based on administrative data. Categorization of exposure was by survey response at the hospital level.
conclusionsAdoption of an intensivist staffing model was not associated with improved mortality in Medicare beneficiaries. These findings suggest that the lower mortality rates previously observed at hospitals with intensivist staffing may be attributable to other factors.
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