ArticleJournal of general internal medicine2020
Comparing Outcomes and Costs of Medical Patients Treated at Major Teaching and Non-teaching Hospitals: A National Matched Analysis.
Article in Journal of general internal medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 1 of them a synthesis that pooled it.
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Who cites it
36 citing papers in PubMed, 1 synthesis or guideline pooled it, 74 citations in OpenAlex.
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- Understanding the role of asthma in acute chest syndrome: a comparative analysis of patients with and without asthma.Annals of hematology · 2025Article
- Readmission Mortality After TAVR: The Combined Effect of Teaching Hospital Status and Cause of Readmission.CJC open · 2025Article
- The estimation of healthcare cost of kidney transplantation in Japan using large-scale administrative databases.Clinical and experimental nephrology · 2025Article
- Comparing clinical practice habits among obesity medicine physicians by patient, physician and clinic factors.Obesity pillars · 2025Article
- Patient Complexity, Social Factors, and Hospitalization Outcomes at Academic and Community Hospitals.JAMA network open · 2025Article
- Evaluation of Health Resource Efficiency and Its Influencing Factors in Ethnic Minority Areas of Guangxi: Data from 2010 to 2022.Risk management and healthcare policy · 2025Article
- Impact of teaching hospital status on postoperative outcomes following posterior cervical fusion/instrumentation.Surgical neurology international · 2025Article
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Corrections and comments
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTeaching hospitals typically pioneer investment in new technology and cultivate workforce characteristics generally associated with better quality, but the value of this extra investment is unclear.
objectiveCompare outcomes and costs between major teaching and non-teaching hospitals by closely matching on patient characteristics.
designMedicare patients at 339 major teaching hospitals (resident-to-bed (RTB) ratios ≥ 0.25); matched patient controls from 2439 non-teaching hospitals (RTB ratios < 0.05).
participantsForty-three thousand nine hundred ninety pairs of patients (one from a major teaching hospital and one from a non-teaching hospital) admitted for acute myocardial infarction (AMI), 84,985 pairs admitted for heart failure (HF), and 74,947 pairs admitted for pneumonia (PNA). EXPOSURE: Treatment at major teaching hospitals versus non-teaching hospitals. MAIN MEASURES: Thirty-day all-cause mortality, readmissions, ICU utilization, costs, payments, and value expressed as extra cost for a 1% improvement in survival. KEY
resultsThirty-day mortality was lower in teaching than non-teaching hospitals (10.7% versus 12.0%, difference = - 1.3%, P < 0.0001). The paired cost difference (teaching - non-teaching) was $273 (P < 0.0001), yielding $211 per 1% mortality improvement. For the quintile of pairs with highest risk on admission, mortality differences were larger (24.6% versus 27.6%, difference = - 3.0%, P < 0.0001), and paired cost difference = $1289 (P < 0.0001), yielding $427 per 1% mortality improvement at 30 days. Readmissions and ICU utilization were lower in teaching hospitals (both P < 0.0001), but length of stay was longer (5.5 versus 5.1 days, P < 0.0001). Finally, individual results for AMI, HF, and PNA showed similar findings as in the combined results. CONCLUSIONS AND RELEVANCE: Among Medicare patients admitted for common medical conditions, as admission risk of mortality increased, the absolute mortality benefit of treatment at teaching hospitals also increased, though accompanied by marginally higher cost. Major teaching hospitals appear to return good value for the extra resources used.
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