But seeing a higher-admitting doc does NOT reduce your likelihood of dying (either within 30 days [shown here], 7 days, 14 days, 90 days, or a year). 6/

Higher-admitting docs also order more radiology and laboratory tests in the ED. This suggests that admission rates may also be reflective of practice pattern intensity more generally. 5/

With data on over 2 million pts across 100 hospitals nationwide, we find that patients treated by docs with higher admission propensities are more likely to be discharged from the hospital within 24 hours when admitted, suggesting a lower clinical need for their hospitalization. 4/

We use rich VA EHR data with info not available in claims data such as ⌚️ of arrival, location within ED, and ESI (a # based on pt severity). This allows us to demonstrate that variation in docs’ admission rates is attributable to docs themselves, not to diffs in pt health. 3/

The decision to admit or discharge a patient is one of the most important decisions an ED doc makes. By how much do ED docs vary in this decision? A lot! Being treated by a doc in top 10% vs bottom 10% can nearly double your probability of admission. 2/

🚨New paper🚨The emergency department (ED) is like a box of chocolates; you never know which doc you're gonna get. What happens when you get a doc that admits patients more often? Are you less likely to die? @stephencoussens and I explore this question in @JAMAInternalMed.🧵1/

The guidelines appear to be last updated in 2021. www.uspreventiveservicestaskforce.org/uspstf/recom...