Once a financially healthy part of American universities, many academic health centers are struggling to survive. Many are merging with for-profit chains or declaring bankruptcy. The advance of managed care and insurance companies focusing on reducing costs appears to be affecting teaching hospitals more than community hospitals. (MSE)

One of the less obvious costs of educational programs is the increased volume of work-ups and treatment for hospitalized patients that are ordered by residents. In a hospital with both private teaching and private nonteaching floors, a comparison shows that service charges on teaching floors are 60 percent higher than on nonteaching floors.…

Information about the consultative practice of nephrology in a community environment was gathered and used to speculate about improvements that could be made in the training of nephrologists in academic medical centers, based on their knowledge of such training. (Author/MLW)

A technique for classifying hospitals on a multidimensional basis was developed. Three major sets of attributes were examined: patient case mix, facility mix, and personnel mix. Using multivariate techniques (factor analysis, cluster analysis, and discriminant analysis), 83 variables were examined for 547 hospitals. A total of six factors were…

The differences between teaching and nonteaching hospitals in complexity and variety of cases seen are described. The results show that teaching hospitals could be expected to cost somewhat more per patient even if case mix were the only factor. (Author/MLW)

A discussion of the social, economic, and interest group considerations in two nursing education issues, concerning hospital-based versus educational institution training and certification of two levels of nurse, focuses on the situation in New Zealand but makes comparisons with the United States and Great Britain. (MSE)

The Medicare prospective payment system does not adequately account for severity of illness. Whether teaching hospitals treat a case mix of patients with more severe illness than do nonteaching hospitals was tested in a study using two severity measures, Horn's severity of illness index and Gonnnella's "disease staging." (Author/MLW)

Analyzes and compares diagnoses made over a five-year period to determine whether differences between diagnoses of students and those of specialists justified further verification by specialized staff, and whether the proportion of such differences had changed with time because of more effective teaching. (WM)

The hospital charges of three groups of patients in one hospital were compared. The results of the study indicated that teaching patients with a faculty attending physician had significantly higher hospital charges, while teaching patients with a community attending physician had charges similar to private, nonteaching patients. (Author/MLW)

A study compared two teaching hospitals' costs for educational programs with annual hospital operating expenses, with inflation, and by program. Unit costs were estimated for graduate and undergraduate medical students. Allocated education costs were 13 percent to 14 percent of operating budgets, in line with medical inflation trends. Cost per…

The extent to which laboratory investigation by interns and residents could be considered "excessive" on general medical floors at a teaching hospital is assessed. The ordering of tests by attending physicians was compared with that of residents at the Royal Victoria Hospital, Montreal, Canada. (MLW)

The transcripts of the 40 students who graduated from Castleton State College (CSC) with a Bachelor of Science in Nursing in 1977, 1978, or 1979 were examined to determine whether registered nurses who graduated from associate degree programs earned higher grade point averages (GPA's) than registered nurses who graduated from hospital-based…

Evidence is presented to support the development of the nursing home as a required clinical educational site. Analogies and differences between the nursing home and the hospital in medical education are explored as a means of understanding the potential and limits of the nursing home's role in medical education. (Author/MLW)

Construction funding for Council of Teaching Hospital (COTH) members has changed dramatically in the past decade. Funding trends are reported for COTH institutions for the years 1969 to 1977, and detailed comparisons are presented for three groups for 1977: COTH state and local government hospitals, COTH voluntary hospitals, and U.S. nonfederal…

A cost containment program initiated in 1975 on the medical teaching service of Charlotte Memorial Hospital, a University of North Carolina affiliated hospital, has led to a significant improvement in hospital house staff utilization of facilities and procedures. In the outpatient setting an actual reduction in patient-encounter cost was realized…