DURHAM, N.C. -- A study conducted by Duke University researchers has found that while it costs more to treat people for hip fractures and other conditions at major teaching hospitals, the survival rate is also higher among people initially treated at these facilities.

The study findings, published in the Jan. 28 issue of The New England Journal of Medicine, examines the survival rates among patients initially treated in five different types of hospitals: major teaching, minor teaching, government-run, for-profit and nonprofit. The researchers compared the survival rates for four conditions -- hip fractures, stroke, coronary heart disease and congestive heart failure -- and found that "survival is better for these common conditions for those initially treated in major teaching hospitals."

The Duke researchers used data from Medicare and the 1982, 1984, 1989 and 1994 National Long Term Care Surveys -- longitudinal surveys of the nation's elderly population that were sponsored by the government's National Institute on Aging -- to measure the costs and survival rates. Adjustments were made for about 20 variables, including age and the health of the patient prior to having a stroke or one of the other three health conditions.

"Basically what we found is that, not surprisingly, major teaching hospitals, primarily those located at universities, cost the Medicare program more than non-teaching hospitals do," said Donald Taylor Jr., an assistant research professor of public policy studies at Duke and one of the study's authors, in an interview. "But we did find evidence that such teaching hospitals did deliver better results."

To calculate costs, the Duke researchers looked at Medicare payments for the initial hospital treatment as well as the first six months of after-care, including home health care and outpatient visits. The study found that:

for hip fractures, the six-month cost at major teaching hospitals c
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Contact: Keith Lawrence
Keith@dukenews.duke.edu
919-681-8059
Duke University
28-Jan-1999