Clinical studyHospital outcomes in major teaching, minor teaching, and nonteaching hospitals in New York state
Section snippets
Hospitals
We obtained information on all patients discharged from 261 hospitals in the state of New York from January 1993 to December 1995 from the Statewide Planning and Research Cooperative System (SPARCS) database. SPARCS is an agency of the New York Department of Health that incorporates data on patients hospitalized in acute care facilities from, among other sources, the uniform bill and uniform discharge abstract submitted by hospitals. Hospital characteristics were merged with the original SPARCS
Results
There were 53 (21%) major teaching, 75 (30%) minor teaching, and 120 (49%) nonteaching hospitals (Table 1). Less than half of the patients were admitted to hospitals providing invasive cardiac procedures. Patients with myocardial infarction were younger and more likely to have been male (Table 1). Heart failure patients had more associated comorbid conditions and a higher mean Charlson Index.
Patients with myocardial infarction were more often transferred from one hospital to another (Table 1).
Discussion
We found that adjusted mortality rates for all three diseases were lower in major teaching hospitals compared with minor teaching or nonteaching hospitals, suggesting a beneficial effect of care at these hospitals. Since adjusted mortality rates were similar, if not higher, in minor teaching than in nonteaching hospitals, the beneficial effect of teaching status—at least as defined in this study—extends only to major teaching hospitals in New York State.
Hospital characteristics have important
References (25)
- et al.
A new method of classifying prognostic comorbidity in longitudinal studiesdevelopment and validation
J Chron Dis
(1987) - et al.
Searching for an improved clinical comorbidity index for use with ICD-9-CM administrative data
J Clin Epidemiol
(1996) - et al.
Hospital characteristics and mortality rates
N Engl J Med
(1989) - et al.
Variations in standardized hospital mortality rates for six common medical diagnosesimplications for profiling hospital quality
Med Care
(1998) - et al.
Hospital characteristics and quality of care
JAMA
(1992) - et al.
Quality of care for two common illnesses in teaching and nonteaching hospitals
Health Aff (Millwood)
(1998) - et al.
Identifying poor-quality hospitalscan hospital mortality rates detect quality problems for medical diagnoses
Med Care
(1996) US teaching hospitals in the evolving health care system
JAMA
(1995)American Hospital Association Statistics
(1997)- et al.
Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases
J Clin Epidemiol
(1993)