QI News and Trends: Bonus Content

Association Between Teaching Status and Mortality in U.S. Hospitals
Journal of the American Medical Association (05/30/17) Vol. 317, No. 20, P. 2105; Burke, Laura G.; Frakt, Austin B.; Khullar, Dhruv

The goal of this observational study was to identify if there is a difference in mortality rates at U.S. teaching hospitals compared with other hospitals across a broad range of medical and surgical conditions. Researchers used national Medicare data to compare mortality rates in U.S. teaching and nonteaching hospitals for all hospitalizations and for common medical and surgical conditions among Medicare beneficiaries aged 65 years and older. They examined approximately 21 million hospitalizations of Medicare beneficiaries at 4,483 hospitals, finding that adjusted 30-day mortality rates were significantly lower at 250 major teaching hospitals compared with 894 minor teaching and 3,339 nonteaching hospitals overall as well as for several individual common medical and surgical conditions. For instance, unadjusted 30-day mortality was 8.1 percent at major teaching hospitals, 9.2 percent at minor teaching hospitals, and 9.6 percent at nonteaching hospitals, reflecting a 1.5 percent mortality difference between major teaching hospitals and nonteaching hospitals. After stratifying by hospital size, 187 large major teaching hospitals had lower adjusted overall 30-day mortality relative to 76 large nonteaching hospitals. Based on their findings, the investigators concluded that among hospitalizations for U.S. Medicare beneficiaries, major teaching hospital status was associated with lower mortality rates for common conditions compared with nonteaching hospitals. However, further research is needed to understand the reasons for these differences, they said.

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