Systematic Review: Association Between Physicians' Clinical Experience and Quality of Care and Patient Outcomes.

IF 4.2 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Mitsuhiro Shimada, Toshiki Kuno, Yu Shindo, Masao Iwagami, Yusuke Tsugawa
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引用次数: 0

Abstract

Background: Physicians with longer clinical experience may accumulate, or conversely exhibit obsolescence of, clinical knowledge and skills.

Objective: This systematic review aims to summarize current evidence of the impact of physician experience on quality of care and patient outcomes.

Methods: We conducted a systematic review by searching EMBASE and MEDLINE databases from 2005 to 2025. Studies were included if they evaluated an association between physician experience-either length of practice or age-and quality of care and patient outcomes (i.e., knowledge, adherence to standard of care, and clinical outcome).

Results: We included 69 studies. Overall, 32 (46%) of 69 studies showed that physicians' experience or age has a negative impact on the quality of care and patient outcomes, whereas 16 (23%) studies reported a positive impact of experience or age. The negative impact of physician experience was observed in the knowledge and adherence to the standard of care domains: 12 (52%) of 23 studies in the knowledge domain and 14 (61%) of 23 studies in the adherence domain showed a negative effect of experience or age. We found mixed findings for clinical outcomes; six (26%) of 23 studies reported negative and nine (39%) reported positive associations. These relationships were consistent when we limited the studies with low or moderate risk of bias as well as moderate or low certainty of evidence.

Conclusions: The older age and increased experience of physicians were associated with inferior knowledge and less adherence but not correlated with clinical outcomes.

系统评价:医生临床经验、护理质量和患者预后之间的关系。
背景:具有较长临床经验的医生可能会积累或相反地表现出临床知识和技能的过时。目的:本系统综述旨在总结医生经验对护理质量和患者预后影响的现有证据。方法:检索2005 ~ 2025年EMBASE和MEDLINE数据库进行系统综述。如果研究评估了医生经验(执业时间或年龄)、护理质量和患者结果(即知识、对护理标准的遵守和临床结果)之间的关系,则纳入研究。结果:我们纳入了69项研究。总体而言,69项研究中有32项(46%)表明医生的经验或年龄对护理质量和患者预后有负面影响,而16项(23%)研究报告了经验或年龄的积极影响。在知识和遵守护理标准领域观察到医生经验的负面影响:在知识领域的23项研究中有12项(52%),在依从性领域的23项研究中有14项(61%)显示经验或年龄的负面影响。我们在临床结果方面发现了不同的结果;23项研究中有6项(26%)报告了阴性关联,9项(39%)报告了阳性关联。当我们限制低或中等偏倚风险以及中等或低证据确定性的研究时,这些关系是一致的。结论:年龄越大和经验越丰富的医生与较差的知识和较低的依从性相关,但与临床结果无关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of General Internal Medicine
Journal of General Internal Medicine 医学-医学:内科
CiteScore
7.70
自引率
5.30%
发文量
749
审稿时长
3-6 weeks
期刊介绍: The Journal of General Internal Medicine is the official journal of the Society of General Internal Medicine. It promotes improved patient care, research, and education in primary care, general internal medicine, and hospital medicine. Its articles focus on topics such as clinical medicine, epidemiology, prevention, health care delivery, curriculum development, and numerous other non-traditional themes, in addition to classic clinical research on problems in internal medicine.
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