Table 3.

Patient 30 day mortality between general internists who graduated from a medical school outside the US compared with graduates of a US medical school. Adjusted patient outcomes are percentages

Models	No of hospital admissions (No of physicians)	Adjusted 30 day mortality (95% CI)		Adjusted odds ratio (95% CI) international v US graduates	P value
		International graduates	US graduates
Model 1: risk adjusted 30 day mortality*	1 215 490 (44 227)	11.1 (11.1 to 11.2)	11.7 (11.6 to 11.8)	0.94 (0.92 to 0.95)	<0.001
Model 2: model 1+physician characteristics†	1 181 913 (42 854)	11.2 (11.1 to 11.3)	11.6 (11.5 to 11.7)	0.96 (0.94 to 0.98)	<0.001
Model 3: model 2+hospital fixed effects‡	1 180 879 (42 710)	11.2 (11.1 to 11.3)	11.6 (11.5 to 11.7)	0.95 (0.93 to 0.96)	<0.001

*Risk adjustment using patient age, sex, race, primary diagnosis, coexisting conditions (Elixhauser comorbidity index), median household income, Medicaid status, year indicators, and day of week.

†Include age, sex, and patient volume.

‡Hospital fixed effects allowed an effective comparison of patient outcomes between international and US graduates within the same hospital.