Med Care. 1985 Apr;23(4):283-95. doi: 10.1097/00005650-198504000-00001.

Case-mix and cost differences between teaching and nonteaching hospitals.

Medical care

A P Frick, S G Martin, M Shwartz

PMID: 3921782 DOI: 10.1097/00005650-198504000-00001

Abstract

The case loads of 11 teaching and 20 nonteaching hospitals are compared, using the original 383 diagnosis-related groups (DRGs) to analyze the extent to which case-mix differences contribute to differences in average cost per case. Case-mix differences are concentrated in a small proportion of DRGs. Teaching hospitals have relatively more surgery cases and neoplasms, and nonteaching hospitals have more cases with heart conditions and infectious diseases. Most nonteaching hospitals have a similar case mix, but among the teaching hospitals, there are two distinct case-mix types, one with which only teaching hospitals are correlated, one that correlates with both teaching and nonteaching hospitals. The average cost per case is more than 60% more expensive in teaching hospitals. Only approximately one quarter of this higher cost is accounted for by case-mix differences. The rest results from the fact that patients in the same DRGs cost more, on average, in teaching than in nonteaching hospitals.

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MeSH terms

• Adult
• Costs and Cost Analysis*
• Diagnosis-Related Groups*
• Factor Analysis, Statistical
• Female
• Hospitals, Teaching / economics
• Humans
• Male
• Medicare
• Middle Aged
• New York

Publication Types

• Comparative Study
• Journal Article
• Research Support, Non-U.S. Gov't
• Research Support, U.S. Gov't, Non-P.H.S.

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