Even when taking into account the increased resources used for surgeries, performing general and vascular procedures on patients in major teaching hospitals may be a better value compared to non-teaching hospitals, according to a study published this week in the Annals of Surgery.
The main reason: higher 30-day survival rates.
In the study, Penn Medicine and Children's Hospital of Philadelphia (CHOP) researchers looked at high-risk patients, including those with multiple chronic diseases, as they sought to quantify the value of receiving care at teaching hospitals. They examined data from more than 350,000 Medicare beneficiaries that underwent general, vascular or orthopedic surgery at more than 2,700 U.S. hospitals including 340 major teaching hospitals.
They compared 30-day postoperative outcomes and costs of surgical procedures.
Among general surgery patients with the highest risk, the mortality rate was 15.9% at teaching hospitals compared to 18.2% at non-teaching hospitals. The mortality rate of high-risk vascular surgery patients was 15.5% at teaching hospitals compared to 16.4% at non-teaching hospitals.
The value of those differences can add up. They calculated the overall value of general surgery was $965 for a 1% reduction in the mortality rate while the overall value for orthopedic surgery was $3,567.
That could translate to up to $168,200 per life saved, researchers aid.
However, when it came to orthopedic surgery, the study found resource costs were higher at teaching hospitals without mortality being significantly different.
"Academic medical centers are often recognized for their ability to deliver advanced clinical and surgical care, but there has been limited data on which specific patient groups benefit the most—when factoring costs and outcomes—from receiving care at the hospitals," said Lee Fleisher, chairman of anesthesiology and critical care at Penn Medicine and senior author of the study, in a statement.
The study was supported in part from an Association of American Medical Colleges grant.