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Contact: Media Relations Officer
AAMC Study Reaffirms Role of U.S. Teaching Hospitals as Leading Providers of Special Surgical Procedures
Washington, D.C., January 13, 2000--Major U.S. teaching hospitals are the dominant providers of many specialized surgical procedures, according to a new study from researchers at the Association of American Medical Colleges (AAMC) and published in the January/February edition of Health Affairs. The greater concentration of specialized surgical procedures at teaching hospitals accounts for, in part, the higher costs often associated with these institutions. The research was conducted by the AAMC's Rebecca Levin, Ernest Moy, M.D., and Paul Griner, M.D.
The AAMC study shows from 1989 to 1995 the volumes of highly specialized and specialized surgeries increased among all hospitals, with major teaching hospitals absorbing a vast majority of these increases. Highly specialized procedures at major teaching hospitals grew from 14,000 in 1989 to 22,470 in 1995, while the number remained essentially flat in other and non-teaching hospitals. Also during this period, highly specialized and specialized surgeries grew from 3.9 percent to 8.9 percent of total surgeries performed in major teaching hospitals.
In the Health Affairs study, Levin et al. conclude that "awareness of how hospitals differ in terms of the procedures they perform helps us to better understand their unique roles in the health care marketplace." They add: "We view our study as a descriptive tool, which along with existing anecdotal and empirical information captures an important segment of the health care landscape today to better inform the decisionmakers of tomorrow."
Specialized surgical procedures often fall into one of three categories: 1) new and emerging technologies; 2) highly complex and rare surgical procedures; and 3) surgical procedures related to the major trauma and burn centers often operated by major teaching hospitals. According to the researchers, patients receiving specialized procedures come from both the poorest and the most affluent neighborhoods. The patients also tend to be younger, minority, and more often male.
"Unless these specialized services are recognized and accounted for with appropriate adjustments for case mix and severity, some hospitals may appear less efficient and lower in quality than their non-teaching competitors," Levin et al. write.
The researchers examined data from the Nationwide Inpatient Sample (NIS) for the years 1989, 1992, and 1995 to identify trends in specialized surgical procedures provided by major teaching hospitals. Data from the AAMC's Council of Teaching Hospitals and Health Systems (COTH) and from the American Hospital Association were used to classify hospitals into three areas: major teaching hospitals, other teaching hospitals, and non-teaching hospitals.
"Concentration of specialized surgical procedures in major teaching hospitals will likely continue," note Levin et al. "This trend has implications not only for these hospitals [teaching hospitals] but for health care purchasers, policymakers, medical educators, and clinical researchers as well."
The research was supported, in part, by The Commonwealth Fund. Health Affairs, published by Project HOPE, is a bimonthly multidisciplinary journal devoted to publishing the leading edge in health policy thought and research. Copies of the January/February 2000 issue will be provided free to interested members of the press. To obtain a copy, contact Christina Danford at Health Affairs, 301-656-7401, ext. 255. The table of contents can also be obtained by visiting the journal's Web site at www.projhope.org/HA.
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The Association of American Medical Colleges represents the 125 accredited U.S. medical schools; the 16 accredited Canadian medical schools; some 400 major teaching hospitals, including 74 Veterans Administration medical centers; 91 academic and professional societies representing nearly 88,000 faculty members; and the nation's 67,000 medical students and 102,000 residents.
Additional information about the AAMC and U.S. medical schools and teaching hospitals is available at www.aamc.org/newsroom.
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