Higher Scores on the LKA Associated with Reduced Post-Hospitalization Death and Readmissions

A recent study published in JAMA Internal Medicine found that patients treated by physicians who perform well on the Longitudinal Knowledge Assessment (LKA®) experience significantly better prognoses—including lower mortality and readmission rates—than those treated by doctors with lower scores.

Analyzing data of more than 260,000 Medicare hospitalizations managed by more than 4,000 internal medicine physicians, researchers discovered a clear connection between medical knowledge and patient survival. Notably the authors were able to account for differences in hospitals by comparing outcomes among physicians with different scores operating in the same hospital.

Patients treated by doctors in the top quartile of performance on the LKA Progress Reports had an 8% lower risk of death within the first seven days of hospitalization compared to those in the bottom quartile.

This is equivalent to about four fewer deaths per 1,000 admissions, a reduction comparable to advances seen in managing major conditions like cardiovascular disease.

The authors also found a 5% reduction in seven-day readmission rates for patients of physicians scoring in the top versus bottom 25% (a difference of 3.1 readmissions per 1,000 hospitalizations), suggesting that stronger clinical knowledge contributes not just to survival but to more effective and lasting care.

A similar association was discovered for 30-day mortality, wherein higher-scoring physicians showed lower mortality rates compared to lower scoring physicians.

This is the first study to assess the prognostic implications for patients whose doctors are using the LKA for continuous certification and coincides with a significant shift in how physicians are approaching certification.