Originally created 08/13/97

Study: Patients have better odds at teaching hospitals



CHICAGO (AP) - A patient stricken with a major illness such as a heart attack or stroke has a better chance of survival at a major teaching hospital, a study suggests.

The researchers also found that these patients have shorter stays at such hospitals.

Teaching hospitals are affiliated with medical schools. Medical students get their training on the job at these hospitals. Such institutions are often heavily involved in medical research as well.

The study involved nearly 90,000 patients treated at 30 hospitals in northeastern Ohio. It was conducted by researchers at Case Western Reserve University in Cleveland, which is affiliated with four of the five major teaching hospitals examined in the study.

The study, published in Wednesday's Journal of the American Medical Association, noted that teaching hospitals tend to cost more than non-teaching community hospitals. And in the current cost-driven health-care environment, they are sometimes perceived as overusing technology.

Teaching hospitals also tend to have a reputation for offering superior care, although not all previous studies have supported that perception.

In an accompanying editorial, Dr. Lisa Iezzoni of Beth Israel Deaconess Medical Center in Boston said the study provides "only limited support to claims of superiority," and she agreed that teaching hospitals are "big, cumbersome and expensive."

But she added: "Society must defy Darwin, supporting our major teaching hospitals for the greater good."

The study looked at patients with six major illnesses: heart attacks, strokes, congestive heart failure, chronic lung disease, gastrointestinal bleeding or pneumonia.

Those treated at major teaching hospitals faced a 19 percent lower risk of dying there. The length of hospitalization - a common measure of efficiency - was 9 percent lower at such institutions than at non-teaching hospitals.

"If generalizable to other metropolitan regions, the findings suggest that care in major teaching hospitals may be associated with better outcomes for two widely used measures," wrote the authors, led by Dr. Gary E. Rosenthal, a professor at Case Western's School of Medicine.

The study gave no reason for the findings. But Rosenthal said one reason patients fare better at teaching hospitals may be that such instititutions tend to have more state-of-the-art technology for diagnosing and treating.

A spokeswoman for the American Association of Health Plans, which represents 1,000 managed-care companies that insure at least 125 million Americans, said the study doesn't prove teaching hospitals are better.

Length of stay and patient mortality aren't the only measures of quality, and it is unclear if the study's findings are applicable to other regions of the country, said spokeswoman Susan Pisano.

Still, she said the association will send the study to members for use in evaluating hospitals.