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To Your Health: NLM update Transcript

Teaching hospitals reduce mortality rates?: 07/24/2017

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Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I'm Rob Logan, Ph.D., senior staff, U.S. National Library of Medicine (NLM).

Here is what's new this week in To Your Health - a consumer health oriented podcast from NLM - that helps you use MedlinePlus to follow up on weekly topics.

The likelihood of death declines when older adults are treated at teaching versus other types of hospitals, reports a comprehensive study recently published in the Journal of the American Medical Association.

The study finds the likelihood of dying is 1.5 percent lower 30 days after treatment at a major teaching — compared to non-teaching and other hospitals. A 30-day assessment period for post-treatment mortality is a widely used measure of hospital quality.

The findings also suggest a 1.2 percent lower mortality rate occurs in teaching hospitals after the authors adjusted the study to more directly compare common patient and hospital characteristics.

Overall, the study's lead author told HealthDay (and we quote): 'for every 84 patients treated at a major teaching hospital that otherwise would have gone to a non-teaching hospital, one fewer patient dies' (end of quote).

The study also suggests there would be about 58,000 fewer patient deaths in the U.S. per year if death rates were the same at non-teaching as teaching hospitals.

The study's findings are based on 21 million hospitalizations of Medicare beneficiaries at about 4,500 hospitals nationwide from 2012-2014. The study's five authors assessed post-hospitalization death rates from 15 common medical conditions, such as pneumonia and chest pain, as well as six surgical procedures, including hip replacement and heart bypass.

The authors operationally defined 'major teaching hospitals' as members of the Council of Teaching Hospitals (COTH) across the U.S. Two types of non-teaching facilities were identified as hospitals that are neither COTH members nor affiliated with a medical school and hospitals that are associated with medical schools but are not COTH members.

The authors, who are mostly from the T.H. Chan School of Public Health at Harvard University, report the study's findings are consistent with some previous research but are more grounded by a comprehensive, nationwide assessment.

Interestingly, the authors do not explain why mortality discrepancies exist in major teaching versus other hospital settings. While authors note the study did not assess the reasons for the differences, they hope the issues raised by the findings will generate future research.

While the authors explain some insurance networks occasionally exclude supporting teaching hospitals because of higher patient costs and alleged, similar clinical results, they conclude (and we quote): 'the findings of the study suggest that teaching hospitals have better outcomes, calling into question whether the national approach to measuring and rewarding on (overall) performance is working effectively' (end of quote).

Meanwhile, MedlinePlus.gov's health facilities health topic page provides a guide to selecting hospitals within the 'start here' section. The Joint Commission (a U.S. hospital accreditation organization) provides additional information on choosing quality ambulatory and behavioral health care as well as enhanced laboratory services within the 'related issues' section of MedlinePlus.gov's health facilities health topic page.

The Centers for Medicare & Medicaid Services provides a nationwide database to compare hospitals, physicians, insurance plans, and suppliers within the 'find an expert' section of MedlinePlus.gov's health facilities health topic page.

MedlinePlus.gov's health facilities health topic page also provides links to the latest pertinent journal research articles, which are available in the 'journal articles' section. You can sign up to receive updates about health facilities as they become available on MedlinePlus.gov.

To find MedlinePlus.gov's health facilities health topic page, please type 'health facilities' in the search box on MedlinePlus.gov's home page, then, click on 'health facilities (National Library of Medicine).' MedlinePlus also has health topic pages devoted to patient safety, hospice care, and nursing homes.

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It was nice to be with you. Please join us here next week and here's to your health!