Association Between Teaching Status and Mortality in US Hospitals

IMPORTANCE: Few studies have analyzed contemporary data on outcomes at US teaching hospitals vs nonteaching hospitals. OBJECTIVE: To examine risk-adjusted outcomes for patients admitted to teaching vs nonteaching hospitals across a broad range of medical and surgical conditions. DESIGN, SETTING, AND...

Full description

Saved in:
Bibliographic Details
Published in:JAMA : the journal of the American Medical Association 2017-05, Vol.317 (20), p.2105-2113
Main Authors: Burke, Laura G, Frakt, Austin B, Khullar, Dhruv, Orav, E. John, Jha, Ashish K
Format: Article
Language:English
Subjects:
Aged
Female
Hospital Bed Capacity
Hospital Mortality
Hospitalization
Hospitals
Hospitals - statistics & numerical data
Hospitals, Teaching - statistics & numerical data
Humans
Male
Medicare
Mortality
Original Investigation
Quality of Health Care
Surgery
Teaching hospitals
United States
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:IMPORTANCE: Few studies have analyzed contemporary data on outcomes at US teaching hospitals vs nonteaching hospitals. OBJECTIVE: To examine risk-adjusted outcomes for patients admitted to teaching vs nonteaching hospitals across a broad range of medical and surgical conditions. DESIGN, SETTING, AND PARTICIPANTS: Use of national Medicare data to compare mortality rates in US teaching and nonteaching hospitals for all hospitalizations and for common medical and surgical conditions among Medicare beneficiaries 65 years and older. EXPOSURES: Hospital teaching status: major teaching hospitals (members of the Council of Teaching Hospitals), minor teaching hospitals (other hospitals with medical school affiliation), and nonteaching hospitals (remaining hospitals). MAIN OUTCOMES AND MEASURES: Primary outcome was 30-day mortality rate for all hospitalizations and for 15 common medical and 6 surgical conditions. Secondary outcomes included 30-day mortality stratified by hospital size and 7-day mortality and 90-day mortality for all hospitalizations as well as for individual medical and surgical conditions. RESULTS: The sample consisted of 21 451 824 total hospitalizations at 4483 hospitals, of which 250 (5.6%) were major teaching, 894 (19.9%) were minor teaching, and 3339 (74.3%) were nonteaching hospitals. Unadjusted 30-day mortality was 8.1% at major teaching hospitals, 9.2% at minor teaching hospitals, and 9.6% at nonteaching hospitals, with a 1.5% (95% CI, 1.3%-1.7%; P 
ISSN:0098-7484
1538-3598
DOI:10.1001/jama.2017.5702