Costs of care similar or lower at teaching hospitals compared to non-teaching hospitals

June 07, 2019

Boston, MA - Total costs of care are similar or somewhat lower among teaching hospitals compared to non-teaching hospitals among Medicare beneficiaries treated for common medical and surgical conditions, according to a new study led by researchers from Harvard T.H. Chan School of Public Health and Beth Israel Deaconess Medical Center.

"These findings are surprising," said senior author Ashish Jha, director of the Harvard Global Health Institute and K.T. Li professor of global health at Harvard T.H. Chan School of Public Health. "We always assumed that we had to trade-off the better outcomes at teaching hospitals with higher costs. It appears that, at least as far as Medicare is concerned, their payments for care are actually a bit less when patients go to a teaching hospital."

The study will be published June 7, 2019 in JAMA Network Open.

Teaching hospitals, which educate and train healthcare professionals, are generally considered to be more expensive than non-teaching hospitals, and some insurers and policymakers have advocated shifting care away from these institutions to lower healthcare spending for patients. However, the degree to which treatment at major teaching hospitals is associated with higher healthcare spending in general and for Medicare, the largest national payer, is not well understood.

For this study, researchers analyzed data from more than 1.2 million hospitalizations among Medicare beneficiaries age 65 and older at more than 3,000 major, minor, and non-teaching hospitals from 2014 to 2015 for some of the most common medical and surgical conditions, including pneumonia, congestive heart failure, and hip replacement. They drew from deidentified administrative Medicare claims data.

They found that major teaching hospitals had higher initial hospitalization costs than non-teaching hospitals, but that the total costs of care for the first 30 days after the hospitalization were lower at major teaching hospitals, largely due to lower costs for follow-up care and readmissions. Costs were similar at teaching and non-teaching hospitals at 90 days after hospitalization.

"These findings support the idea that to truly understand variation in health care costs, it's important to look not at just what happens in the hospital but on total spending for an acute episode," said first author Laura Burke, assistant professor of emergency medicine at Harvard Medical School and Beth Israel Deaconess Medical Center and instructor in the Department of Health Policy and Management at Harvard Chan School.
-end-
Other Harvard Chan School authors included Jie Zheng, Austin Frakt, and E. John Orav.

Funding for this study came from the Association of American Medical Colleges.

"Comparison of costs of care for Medicare patients hospitalized in teaching and non-teaching hospitals," Laura G. Burke, Dhruv Khullar, Jie Zheng, Austin B. Frakt, E. John Orav, Ashish K. Jha, JAMA, June 7, 2019, doi: 10.1001/jamanetworkopen.2019.5229

Visit the Harvard Chan School website for the latest news, press releases, and multimedia offerings.

Harvard T.H. Chan School of Public Health brings together dedicated experts from many disciplines to educate new generations of global health leaders and produce powerful ideas that improve the lives and health of people everywhere. As a community of leading scientists, educators, and students, we work together to take innovative ideas from the laboratory to people's lives--not only making scientific breakthroughs, but also working to change individual behaviors, public policies, and health care practices. Each year, more than 400 faculty members at Harvard Chan School teach 1,000-plus full-time students from around the world and train thousands more through online and executive education courses. Founded in 1913 as the Harvard-MIT School of Health Officers, the School is recognized as America's oldest professional training program in public health.

Harvard T.H. Chan School of Public Health

Related Public Health Articles from Brightsurf:

COVID-19 and the decolonization of Indigenous public health
Indigenous self-determination, leadership and knowledge have helped protect Indigenous communities in Canada during the coronavirus disease 2019 (COVID-19) pandemic, and these principles should be incorporated into public health in future, argue the authors of a commentary in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.200852.

Public health consequences of policing homelessness
In a new study examining homelessness, researchers find that policy such a lifestyle has massive public health implications, making sleeping on the street even MORE unhealthy.

Electronic health information exchange improves public health disease reporting
Disease tracking is an important area of focus for health departments in the midst of the COVID-19 pandemic.

Pandemic likely to cause long-term health problems, Yale School of Public Health finds
The coronavirus pandemic's life-altering effects are likely to result in lasting physical and mental health consequences for many people--particularly those from vulnerable populations--a new study led by the Yale School of Public Health finds.

The Lancet Public Health: US modelling study estimates impact of school closures for COVID-19 on US health-care workforce and associated mortality
US policymakers considering physical distancing measures to slow the spread of COVID-19 face a difficult trade-off between closing schools to reduce transmission and new cases, and potential health-care worker absenteeism due to additional childcare needs that could ultimately increase mortality from COVID-19, according to new modelling research published in The Lancet Public Health journal.

The Lancet Public Health: Access to identification documents reflecting gender identity may improve trans mental health
Results from a survey of over 20,000 American trans adults suggest that having access to identification documents which reflect their identified gender helps to improve their mental health and may reduce suicidal thoughts, according to a study published in The Lancet Public Health journal.

The Lancet Public Health: Study estimates mental health impact of welfare reform, Universal Credit, in Great Britain
The 2013 Universal Credit welfare reform appears to have led to an increase in the prevalence of psychological distress among unemployed recipients, according to a nationally representative study following more than 52,000 working-age individuals from England, Wales, and Scotland over nine years between 2009-2018, published as part of an issue of The Lancet Public Health journal on income and health.

BU researchers: Pornography is not a 'public health crisis'
Researchers from the Boston University School of Public Health (BUSPH) have written an editorial in the American Journal of Public Health special February issue arguing against the claim that pornography is a public health crisis, and explaining why such a claim actually endangers the health of the public.

The Lancet Public Health: Ageism linked to poorer health in older people in England
Ageism may be linked with poorer health in older people in England, according to an observational study of over 7,500 people aged over 50 published in The Lancet Public Health journal.

Study: Public transportation use linked to better public health
Promoting robust public transportation systems may come with a bonus for public health -- lower obesity rates.

Read More: Public Health News and Public Health Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.