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Association Between Teaching Status and Mortality in US Hospitals
Laura G Burke1, Austin B Frakt2, Dhruv Khullar3
1Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts2Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
JAMA
|May 24, 2017
Summary
Major teaching hospitals showed lower mortality rates for Medicare patients compared to nonteaching hospitals. These findings highlight potential benefits of care at academic medical centers.
Area of Science:
- Health Services Research
- Comparative Effectiveness Research
- Hospital Quality Improvement
Background:
- Limited contemporary data exist on patient outcomes comparing US teaching and nonteaching hospitals.
- Understanding these differences is crucial for healthcare policy and patient care decisions.
Purpose of the Study:
- To compare risk-adjusted outcomes, specifically mortality rates, for patients admitted to teaching versus nonteaching hospitals.
- The study examined a wide range of medical and surgical conditions in Medicare beneficiaries.
Main Methods:
- Utilized national Medicare data for over 21 million hospitalizations across US hospitals.
- Categorized hospitals into major teaching, minor teaching, and nonteaching based on affiliations.
- Analyzed 30-day mortality rates as the primary outcome, adjusting for patient and hospital characteristics.
Main Results:
- Major teaching hospitals demonstrated lower unadjusted and adjusted 30-day mortality rates compared to nonteaching hospitals.
- This survival benefit was observed across various hospital sizes (large, medium, and small).
- Specifically, large major teaching hospitals had a 1.2% lower adjusted mortality rate than large nonteaching hospitals.
Conclusions:
- Major teaching hospital status is associated with significantly lower mortality rates for Medicare beneficiaries.
- These findings suggest potential advantages in patient outcomes at academic medical centers.
- Further research is warranted to elucidate the specific factors contributing to these observed mortality differences.
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