Teaching hospitals: A myth dispelled

Managed care organizations have tended to keep teaching hospitals at arm’s length because the institutions have had the reputation of being more expensive than their nonteaching counterparts due to their obligation to provide medical education, sponsor research, and offer a broad spectrum of clinical services. There’s been little evidence to prove otherwise until a recent study that compared severity-adjusted mortality and length of stay (LOS) in both types of facilities.1

Ninety thousand patients with myocardial infarctions, congestive heart failure, obstructive airway disease, gastrointestinal hemorrhage, pneumonia, or stroke were part of the study at Case Western Reserve University School of Medicine in Cleveland. Nineteen nonteaching hospitals, six minor teaching hospitals, and five major teaching hospitals were examined in the study.

The authors wrote, "We found that the risk of death was 19% lower in major teaching hospitals, compared with nonteaching hospitals, and that length of stay was nearly 10% lower." Mortality and LOS were generally similar in minor teaching hospitals.


1. Rosenthal GE, Harper DL, Quinn LM, et al. Severity-adjusted mortality and length of stay in teaching and nonteaching hospitals. JAMA 1997; 278:485-490.