Do Teaching Hospitals Offer Better Mortality Rates?

There are many misconceptions about teaching hospitals, but the easiest mistake to make is to assume that because residents with less experience are involved at the hospital it means that patients will receive a lower standard of care. However, a new study published in JAMA shows that what may sound like a logical conclusion does not hold up.

When researchers in the Boston area, led by Laura G. Burke, MD, MPH, Instructor in Emergency Medicine at the Harvard T.H. Chan School of Public Health, set out to examine this very question, they found that data from previous studies was, in many cases, decades old. To gather new data, the researchers looked at hospitalizations from 4,483 different hospitals across the U.S, taking only data from 2012-2014. The researchers then examined the mortality rates for specific medical conditions and surgeries, such as stroke, heart failure or hip replacement.

Mortality Rates 20170529

In their analysis of 21.5 million hospitalizations of Medicare patients, the researchers found that the 30-day mortality rates were significantly better at major teaching hospitals, even when patient data was adjusted for age and the severity of illness, or when the hospital data was adjusted for size of hospital, etc. The 7-day and 90-day mortality rates were also better at the major teaching hospitals when compared to non-teaching hospitals.

Because of their close association with medical schools, teaching hospitals may be at the forefront of medical research, hosting residents who are being trained in the most up-to-date techniques and treatments. According to some doctors, the presence of residents alone keeps the attending surgeons on their toes – Jon Schellack, a vascular surgeon in Baton Rouge, Louisiana was quoted in U.S. News and World Report explaining that “The medical students and the residents are very inquisitive, and they are also always looking up the patient’s problem and diagnosis and researching it and challenging me and asking me questions.”

Lead author Dr Laura Burke speculates that “Academic medical centers provide a unique environment, with 24-hour availability of specialty services, advanced technologies, and some of the most expert physicians in the country,” as quoted in the School of Public Health press release. Co-author Professor Ashish Jha added, “We find that across a very wide range of medical and surgical conditions, patients receiving care at teaching hospitals have superior outcomes.”

If you’re trying to decide what type of residency you should choose, read this first.

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Laurie Breen

Laurie Breen is a freelance writer well-versed in research communications and grant writing. She received her Bachelors Degree in Psychology from Smith College and has worked previously at the University of Queensland's Centre for Clinical Research in Brisbane, Australia. Her favorite conversational topic is "antibiotic-resistant bacteria," making her a big hit at parties.