 |
 |
------------------------------------------------------------------------ Better Patient Outcomes Argue For Preservation Of Teaching Hospitals ------------------------------------------------------------------------ WESTPORT, Aug 13 (Reuters) - Patients treated in a major teaching hospital appear to have better outcomes than those treated at other hospitals, according to a report in the August 13 issue of JAMA. "These findings are noteworthy at a time when the viability of many major teaching hospitals is threatened by powerful healthcare market forces and by potential changes in federal financing of graduate medical eduction," Dr. Gary E. Rosenthal of the Case Western Reserve University School of Medicine and colleagues there and elsewhere in Cleveland, Ohio, explain in their report. The researchers analyzed the outcomes of nearly 90,000 consecutive patients discharged with one of six common conditions--myocardial infarction, congestive heart failure, obstructive airway disease, gastrointestinal hemorrhage, pneumonia, or stroke--from 30 hospitals in northeast Ohio between 1991 and 1993. Those discharged from large teaching hospitals had a 19% lower risk of mortality during the 29-month period and a 9% shorter length of stay, compared with patients discharged from nonteaching hospitals. "In contrast, mortality and [length of stay] were generally similar in minor teaching hospitals," Dr. Rosenthal points out, "...indicating that the potential advantages of major teaching hospitals [are] probably not related to teaching status, per se, but to other aspects of the organization and delivery of hospital care." The Ohio researchers explain that their "...findings have important implications for healthcare policy and purchasing." Although care is often more expensive at teaching hospitals, the "...finding of a lower [length of stay] suggests that, for some aspects of care, major teaching hospitals may be more efficient." In addition, teaching hospitals provide "...important societal functions." In a related editorial, Dr. Lisa I. Iezzoni of Harvard Medical School in Boston, Massachusetts, explains that in a healthcare system driven by "survival of the fittest," if the fittest are those who can compete on the basis of price, teaching hospitals are surely on their way to extinction. But the increased quality of care, medical education and research provided by these institutions suggest that "...society must defy Darwin, supporting our major teaching hospitals for the greater good." JAMA 1997;278:485-490,520. Copyright 1997 Reuters Limited. <http://www.reutershealth.com/news/docs/199708/19970813pra.html> ------------------------------------------------------------------ [log in to unmask]