US teaching hospitals in the evolving health care system

Article Abstract:

Changes in the US health care system are reshaping the role and function of teaching hospitals. As the medical marketplace evolves, the financial viability of teaching hospitals is threatened. Trends in insurance coverage and insurers payment policies may disrupt the complex financing system that supports teaching hospitals. Since the 1980s there has been growing concern about an oversupply of physicians and an overabundance of medical specialists. The private sector will act slowly and inadequately to address the oversupply of specialists. Legislation to increase funding to teaching hospitals and regulate the supply of physicians was not enacted in 1992 or 1994 and is unlikely to generate support in the conservative fiscal environment of 1995. Teaching hospitals will respond to changes in the health care system by seeking new sources of funding, filling a unique market niche, and consolidating. Teaching hospitals will follow diverse paths in the health care system of the future.

Medicine, Supply and demand, Physicians, Medical professions, Medical specialties

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The relationship of house staff experience to the cost and quality of inpatient care

Article Abstract:

The inexperience of house staff may contribute to the increased cost of care at teaching hospitals. The relation between house staff experience and the quality of inpatient care was examined at one teaching hospital. Experience of the house staff was defined by the month of the academic year in which patient care was given. Cost was measured by the length of hospital stay and total hospital charges, and quality was determined by hospital deaths, hospital re-admissions, and nursing home placements. The results demonstrate that increasing house staff experience was associated with decreases in the length of hospital stay and hospital charges. There was no relation between house staff experience to hospital deaths, re-admissions or nursing home placements. Thus the process of training inexperienced physicians may result in inefficiency and increased costs in teaching hospitals. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Economic aspects, Medical care, Cost of, Health care costs, Medical education, Graduate medical education, Postgraduate medical education

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The Perilous State of Academic Medicine

Article Abstract:

Congress should do its part to provide financial support to the network of teaching hospitals and medical schools in the US. The US healthcare system is the envy of the world and most Americans believe that an academic medical center provides the best care. Academic medical centers are those that are affiliated with a medical school. Academic medical centers are losing money partly because of government cutbacks and a managed care industry that does not want to pay for indigent care. Possible solutions include universal health insurance, a Medicare prescription drug benefit, and increased public funding of academic medical centers.

Hospitals, University, University hospitals

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