title: Contemporary performance of U.S. teaching and nonteaching hospitals.
abstract: OBJECTIVE
  To compare the performance of U.S. teaching and nonteaching hospitals using a portfolio of contemporary, publicly reported metrics.
  
  
  METHODS
  The authors classified acute care general hospitals filing a Medicare Institutional Cost Report according to teaching intensity: nonteaching, teaching, or Council of Teaching Hospitals member. They compared aggregate results across categories for Hospital Compare process compliance, mortality, and readmission rates (acute myocardial infarction [AMI], heart failure, pneumonia); Surgical Care Improvement Project (SCIP) performance; compliance with Leapfrog standards; patient experience; patient services and key technologies; safety (computerized physician order entry, intensive care unit staffing, National Quality Forum safe practices, hospital-acquired conditions); and cost/resource utilization (Medicare-adjusted expense per case; Leapfrog efficiency and resource use standards).
  
  
  RESULTS
  Availability of patient services and advanced technologies were associated with teaching intensity (P < .0001), as were most hospital safety metrics. Teaching intensity was favorably associated with SCIP performance, AMI and heart failure process scores, and mortality (P < .0001). It was unfavorably associated with higher AMI and pneumonia readmission rates (P < .0001) and lower scores for individual patient satisfaction measures. Costs per case were similar (P = .4194) across hospital categories after correction for federally allowed adjustments (case mix, wages, and low-income patient care).
  
  
  CONCLUSIONS
  Teaching hospitals offer advanced clinical capabilities, educate the next generation of providers, care for disadvantaged urban populations, and are leaders in health care research and innovation. However, many stakeholders may be unaware of an additional value-relatively higher quality and safety in many areas, with similar adjusted costs.
authors.affiliation: Center for Quality and Safety, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA. dshahian@partners.org
authors.forename: David M
authors.initials: DM
authors.lastname: Shahian
authors.forename: Paul
authors.initials: P
authors.lastname: Nordberg
authors.forename: Gregg S
authors.initials: GS
authors.lastname: Meyer
authors.forename: Bonnie B
authors.initials: BB
authors.lastname: Blanchfield
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Mort
authors.forename: David F
authors.initials: DF
authors.lastname: Torchiana
authors.forename: Sharon-Lise T
authors.initials: SL
authors.lastname: Normand
mesh_terms: D019983:Guideline Adherence / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006295:Health Resources / Q000706:statistics & numerical data; D017721:Hospital Costs / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006761:Hospitals / Q000592:standards; D006784:Hospitals, Teaching / Q000191:economics / Q000592:standards*; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D010359:Patient Readmission / Q000706:statistics & numerical data; D061214:Patient Safety / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000191:economics / Q000706:statistics & numerical data*; D014481:United States