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Analysis in Brief

Each online issue of Analysis in Brief (AIB) tackles an academic medicine research topic, and presents a two-page, easy-to-read snapshot of the AAMC’s data collection and research activities. Topics are selected through a peer-review process and support the association’s strategic research agenda.  The reports not only present data, but also provide context on the issues, interpretation of results and trends, and discussion of the policy and practical implications of the results—all of which may help to facilitate institutional and policy improvements at medical schools and teaching hospitals.

In addition to the latest issue highlighted here, you can access the Analysis in Brief archives and download the free PDF reports.

July 2019 Teaching Hospitals Are Critical Providers of Care for Medicare Hospital Transfer Patients

Teaching Hospitals Are Critical Providers of Care for Medicare Hospital Transfer Patients

One way in which teaching hospitals continue to demonstrate their advanced capabilities and serve as indispensable resources to their communities is in treating a disproportionate share of transfer patients from other hospitals. These patients have been found to be higher acuity than average patients, spending more time in the intensive care unit, being less likely to discharge directly to home, and ultimately costing more to treat. Given recent changes in coverage due to the Affordable Care Act, advances in technology, and changes in clinical care models, this Analysis in Brief updates previous research and (1) examines whether transfer patients are disproportionately sent to teaching hospitals, (2) assesses the complexity of transfer patients, and (3) determines whether teaching hospitals are sufficiently compensated for the costs they bear in treating a disproportionate share of these resource-intensive patients. Results show that in 2016, while teaching hospitals only accounted for less than one-third of all IPPS hospitals, four out of every five transfer cases were treated at teaching hospitals. The average Case Mix Index (CMI) for these transfer cases is higher than that for nontransfer cases across each hospital category, with AAMC-member teaching hospitals receiving the most clinically complex cases. Finally, while Medicare underpaid for both transfer and nontransfer cases, transfer cases were more severely underpaid than nontransfer cases for AAMC-member teaching hospitals. These findings demonstrate that teaching hospitals continue to play a significant role in providing specialized and intensive care to patients when other hospitals cannot and affirms their continued value as important community and regional assets.

Supplemental Information

No supplemental information for this edition of Analysis in Brief.

Related Resources

Medicare Patient Hospital Transfers in the Era of Health Care Reform  (April 2013 AIB)

Financial and Clinical Impact of Transfer Patients at Major Teaching Hospitals (Academic Medicine June 2019 article)