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Invited Critique
February 16, 2009

Hospital Teaching Intensity, Patient Race, and Surgical Outcomes—Invited Critique

Arch Surg. 2009;144(2):121. doi:10.1001/archsurg.2008.568

Teaching hospitals play a major role in the US health care delivery system.14 Patients and the public expect that care provided by graduate physicians in specialized training programs will provide care equal to, if not superior to, care provided in hospitals without graduate teaching programs. The expectation that care provided would be equal or superior is based on the probability that hospitals with training programs have specific resources directed toward supporting the educational mission, which could extend to improved patient care. In addition, teaching hospitals typically have higher nurse to patient care ratios, greater availability of technology, and higher volume, especially in complex conditions.3 However, patients at teaching hospitals often have more comorbid diseases, and likely, many other unmeasured factors may be present. Thus, the assessment and attribution of cause about these differences is problematic.

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