Teaching Hospitals

Teaching hospitals have recently been faced with many new challenges. With the introduction of managed health care, medicine has entered a state of transition. In order to control costs, hospitals have begun to place considerable emphasis on primary care. Although such practices generally result in greater efficiency, they create problems for academic medical centers. Managed health care could, for example, threaten the centers' financial security: Tax-subsidized teaching hospitals might be made more accountable for their expenditures. Despite shifts in the political climate, widespread reform among academic medical centers is inevitable. There are many different ways that academic hospitals' operations could be improved. Reform might, for instance, involve reorganization and downsizing.

Health care in the United States is undergoing a transformation (Jones, 1993, p. 220). Up until about the late 19th century, "doctoring in America was a catch-as-catch-can business" (Flanigan, 1995, pp. D1, D6). With the eventual creation of high standards for treatment, however, medicine became a profession. By the mid-20th century, most physicians provided care on a fee-for-service basis and practically everyone had access to medical care. In recent years though, the health care system has become unacceptably expensive. Upward pressures on the medical economy include general inflation, high technology costs, and the need to care

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r (average beds equals 563, as compared to 174 for all hospitals), they are more expensive (average costs equal $7,814 per admission, as compared to $4,521 for nonteaching hospitals), and they have higher occupancy rates (78 percent on average, as compared with 55 percent for all hospitals). In addition, hospital stays in teaching hospitals are typically longer (7.7 days, as compared to 6.9 days for all hospitals) and the facilities have more full-time-equivalent employees per patient (6.9, as compared with 5.4 for all hospitals). The economic foundations of academic medical centers may be characterized by their fragility. As a rule, the activities of such centers do not pay for themselves. According to Iglehart (1993), no conclusive study has compared, for example, the costs added by residency programs with the service benefits that residents provide. However, it is widely believed that the costs of operating a residency program exceed the value of any extra benefits obtained by patients. In addition, both biomedical research, as well as the treatment of severe or unusual diseases, can be costly. Furthermore, although the nation's teaching hospitals contain only about 18 percent of the nation's acute care beds, they provi
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Some common words found in the essay are:
Consortium UHC, Moreover Republican, Institutes Health, According Rogers, Medical Colleges, United States', According Iglehart, According UHC, D1 D6, Associating HMO, academic medical, medical centers, health care, academic medical centers, teaching hospitals, managed care, 1995 pp, iglehart 1993, 1993 pp, 1993 pp 1052-1056, iglehart 1993 pp, pp 1052-1056, primary care, 1995 pp 407-411, iglehart 1995 pp,
Approximate Word count = 3227
Approximate Pages = 13 (250 words per page)

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