Context. - Major teaching hospitals are perceived as being more expensive than other hospitals and, thus, unattractive to managed care.
However, little empirical data exist about their relative quality and efficiency.
The current study compared severity-adjusted mortality and length of stay (LOS) in teaching and nonteaching hospitals.
- Retrospective cohort study.
- Thirty hospitals in northeast Ohio.
- A total of 89851 consecutive eligible patients discharged in 1991 through 1993 with myocardial infarction, congestive heart failure, obstructive airway disease, gastrointestinal hemorrhage, pneumonia, or stroke.
- in-hospital mortality and LOS of patients in major teaching (n=5), minor teaching (n=6), and nonteaching (n=19) hospitals were adjusted for admission severity of illness using multivariable models based on demographic and clinical data abstracted from patients'medical records.
- The adjusted odds of death was 19% lower (95% confidence interval [Cl], 2% - 34% ; P=03) for patients in major teaching hospitals compared with nonteaching hospitals but was similar (95% Cl, 7% lower to 28% higher ; P=28) for patients in minor teaching hospitals.
The findings were generally consistent in analyses stratified according to diagnosis, age, race, predicted risk of death, and other covariates.
In addition, risk-adjusted LOS was 9% lower (95% Cl, 8% - 10% ; P<. (...)
Mots-clés Pascal : Mortalité, Temps séjour, Milieu hospitalier, Service hospitalier, Ajustement, Indice gravité, Enseignement universitaire, Etude comparative, Taux, Qualité, Soin, Homme, Epidémiologie, Etats Unis, Amérique du Nord, Amérique, Etude cohorte, Rétrospective
Mots-clés Pascal anglais : Mortality, Residence time, Hospital environment, Hospital ward, Fitting, Severity score, Higher education, Comparative study, Rate, Quality, Care, Human, Epidemiology, United States, North America, America, Cohort study, Retrospective
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0432976
Code Inist : 002B30A04D. Création : 19/12/1997.