Teaching hospitals have lower mortality rates than non-teaching hospitals, study finds

The study found that 30-day mortality rates were 1.5 percent lower at teaching hospitals, and that rate was consistent across nearly every procedure

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Patients admitted to major teaching hospitals are less likely to die compared with patients admitted to minor teaching or non-teaching hospitals, according to a large national study from Harvard T.H. Chan School of Public Health.

The study found that 30-day mortality rates were 1.5 percent lower at teaching hospitals, and that rate was consistent across nearly every procedure and condition, as well as various hospital and patient characteristics.

Previous studies have compared outcomes at U.S. teaching hospitals -- those affiliated with medical schools, at which medical students are trained -- with outcomes at non-teaching hospitals, and have uncovered similar results. But many of those studies are decades old.

For the new study, researchers analyzed data for 21.5 million hospitalizations of Medicare beneficiaries at 4,483 hospitals across the U.S -- 250 major teaching hospitals, 894 minor teaching hospitals, and 3,339 non-teaching hospitals -- between 2012 and 2014. The study looked at 30-day mortality rates for 15 common medical conditions, such as pneumonia, congestive heart failure and stroke, and for six surgical procedures, including hip replacement, coronary artery bypass grafting and colectomy.

The 30-day mortality rate was 8.1 percent at major teaching hospitals, 9.2 percent at minor teaching hospitals, and 9.6 percent at non-teaching hospitals, the study found. The overall 30-day mortality difference between major teaching hospitals and non-teaching hospitals was 1.5 percent, and stayed consistent even after adjusting for factors such as age and severity of illness, and a hospital's size and profit status.

Major teaching hospitals also had lower seven-day and 90-day mortality rates -- by 0.3 percent and 1.6 percent, respectively.

Speculating as to why teaching status was linked with lower mortality, the authors said it's possible that teaching hospitals have greater experience treating particular conditions or may be earlier adopters of technologies and treatments that yield better outcomes for patients. But they said more research is necessary to understand the mechanisms behind the association.

The study examined mortality rates only among Medicare beneficiaries, so it wasn't possible to determine whether the findings could be applied more generally to the non-elderly population.

"Academic medical centers provide a unique environment, with 24-hour availability of specialty services, advanced technologies, and some of the most expert physicians in the country," said Laura Burke, instructor of health policy and management at Harvard Chan School, emergency physician at Beth Israel Deaconess Medical Center, and lead author of the study, in a statement. "This seems to pay off for patients. While obviously not all patients can receive care in major teaching hospitals, understanding which strategies and resources are particularly important to patient outcomes, and how they can be replicated among non-teaching hospitals, is critically important to improve care for all patients."

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