University hospitals may not be all that better than community hospitals

With the exception of cancer care, university hospitals generally do not provide higher quality of care than other hospitals, according to a recent study that evaluated data from 118 university hospitals and compared them with data from general, acute and non-federal U.S. hospitals.

The study, titled “An Assessment of the Quality of University Hospital Care in the U.S.,” found that although university hospitals do very well as a group in cancer care and in overall medical care, in many clinical categories they either performed the same as non-university hospitals or sometimes far worse. For example, 89% of university hospitals fall below the national average in orthopedic care and 85% fall below the national average for general surgery.

“Most people assume that a university hospital will provide better quality care because these institutions typically conduct cutting-edge academic research, have lofty reputations and adopt the latest treatment protocols and technologies,” says Dr. Thane Forthman, managing principal of The Delta Group, which produced the study. “We were especially surprised to see the study reveal that some of the nation’s best-known university hospitals scored in the bottom quartile of all hospitals nationally for overall quality of hospital care.”

Forthman focuses attention on university hospitals’ reliance on interns and residents. “Certainly more research is needed, but at university hospitals you have a large population of interns and residents who are still being trained. While under the supervision of an attending physician, they have the autonomy to make rounds, order lab tests and make clinical decisions, even though they lack time-tested, hands-on experience,” says Forthman.

“More importantly, interns and residents often work extended shifts of up to 80 hours per week, which empirical research has shown dramatically increases fatigue-related medical and diagnostic errors, medication errors and other adverse events.”

Other key study findings included:

* University hospitals appeared more frequently in the top 10% of all hospitals nationally in cancer care : 43% of university hospitals studied performed in the top 10% nationally for cancer care.

* Many highly-regarded university hospitals performed in the bottom 25% of all hospitals nationally for overall quality of hospital care, including: Emory University Hospital, Dartmouth-Hitchcock Memorial Hospital, George Washington University Hospital, Georgetown University Hospital, Hospital of University of Pennsylvania, Stanford Hospital, Shands Hospital at the University of Florida, The Johns Hopkins Hospital, The University of Chicago Medical Center and University of North Carolina Hospital (Chapel Hill).

* Of the 118 university hospitals evaluated, 17 were in the top 10% of all hospitals nationally for overall quality of care in three or more clinical categories:

* University hospital quality scores fall disproportionally below the national average for the majority of clinical categories: Orthopedic Care (89% fall below the national average); General Surgery (85% fall below); Major Orthopedic Surgery and Neurological Care (78% fall below, respectively); Overall Hospital Care (74% fall below); Overall Surgical Care (73% fall below); Major Neuro-Surgery (67% fall below); Cardiac Care (63% fall below); Major Cardiac Surgery (62% fall below).

You’ll find more information on the study here.

You can view the study in its entirety here.

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