Several studies suggest that physicians treat older patients differently from younger patients. In previous work we have reported that interns who have a high workload during call tend to discharge their patients more quickly than interns with more moderate workloads. This article further examines the relationship between workload and patient care, to assess whether the effects of workload on care differ for younger and older patients. Results indicated that as intern workload increased, younger patients tended to have longer hospital stays, while older patients tended to have shorter stays. Similar effects were found for total hospital charges, though we found no such effects for mortality or early hospital readmission. These findings suggest that very busy interns may selectively discharge older patients more quickly. Educators may need to focus attention on discharge planning for older patients, to ensure that care is appropriate even when physician workload is high.
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