Outcomes, costs of Medicare patients having surgery at teaching vs nonteaching hospitals

Editor's Note

This study of Medicare patients at 340 teaching hospitals and matched patient controls at 2,444 nonteaching hospitals found that as risk of mortality increased, the mortality benefit of treatment at teaching hospitals also increased, though with marginally higher costs.

Included in the analysis were 86,751 pairs of general, 214,302 pairs of orthopedic, and 52,025 pairs of vascular surgery patients.

Among general surgery patients:

• mortality was 4.62% in teaching vs 5.57% in nonteaching hospitals, and overall paired cost difference was $915
• for the quintile of pairs with highest mortality risk on admission, mortality differences were larger (15.94%, teaching vs 18.18%, nonteaching), and the paired cost difference was larger at $3773.

Vascular surgery outcomes were similar to general surgery; however, there were no significant differences in orthopedic outcomes between teaching and nonteaching hospitals, but costs were higher at teaching hospitals.