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Do patients in teaching hospitals get better care?

Hospitals where doctors receive training are generally thought of as the most advanced type of hospital. So, for the patient, is it best to be admitted to a 'teaching hospital'? A review of the evidence from international research has concluded that there is no strong evidence that patients in teaching hospitals do better or worse - than those admitted to other hospitals.

Some people have argued that teaching hospitals ought to provide the best care, as they usually have the best equipment and the most highly qualified staff. However, it has also been claimed that, as people in training are involved in providing some of the treatment, patients may face greater risks. Researchers at the University of Ioannina School of Medicine in Greece set out to settle the question. The results of their research are published in PLoS Medicine.

This is a difficulty issue to study. Because of the high reputation of teaching hospitals, the patients whose condition is the most serious are often sent there, with other patients going to nonteaching hospitals. Obviously, it would not be a fair test to compare the most seriously ill patients with those whose condition was less serious.

The University of Ioannina team did not do any new work involving patients. Instead they conducted a thorough search internationally for studies that had already been done, which met criteria that they had specified in advance. This type of research is called a "systematic review". They found 132 studies that had compared the outcomes of patients in teaching or nonteaching hospitals. They were all "observational studies" where researchers had gathered information on what was already taking place, rather than setting up an experiment. In 14 studies, allowances had been made for differences in such factors as the severity of the patients' condition, and whether or not they had more than one type of illness when they were treated. There was a great deal of variability in the resu
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Contact: Andrew Hyde
press@plos.org
44-122-346-3330
Public Library of Science
11-Sep-2006


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