RT Journal
A1 Lipsett PA
T1 HOspital teaching intensity, patient race, and surgical outcomes—invited critique
JF Archives of Surgery
JO Archives of Surgery
YR 2009
FD February 1
VO 144
IS 2
SP 121
OP 121
DO 10.1001/archsurg.2008.568
UL http://dx.doi.org/10.1001/archsurg.2008.568
AB 
Teaching hospitals play a major role in the US health care delivery system.1- 4 Patients and the public expect that care provided by graduate physicians in specialized training programs will provide care equal to, if not superior to, care provided in hospitals without graduate teaching programs. The expectation that care provided would be equal or superior is based on the probability that hospitals with training programs have specific resources directed toward supporting the educational mission, which could extend to improved patient care. In addition, teaching hospitals typically have higher nurse to patient care ratios, greater availability of technology, and higher volume, especially in complex conditions.3 However, patients at teaching hospitals often have more comorbid diseases, and likely, many other unmeasured factors may be present. Thus, the assessment and attribution of cause about these differences is problematic.