Hadley J, Tigue P
Health Policy Educ. 1982 Jul;3(2):157-71. doi: 10.1016/0165-2281(82)90034-0.
This article reports data pertinent to three issues in the financing of graduate medical education: sources of funds for house staff support, the financing of faculty salaries for educational activities, and reimbursement bias in favor of care provided in inpatient settings. Using data from a 1979 hospital survey, we estimate that total expenditures for house-staff stipends and fringe benefits were almost $1.6 billion. Eighty-seven percent of these funds were derived from patient care revenues. Faculty salaries for educational activities added another $376 million to the cost of graduate medical education. Teaching hospitals collected 81 percent of their charges for inpatient care, but only 72.8 percent of charges for outpatient care. However, Medicare and Medicaid reimbursed approximately the same proportion of charges in both settings. The article concludes by arguing that a unified-charge system for paying teaching hospitals would eliminate most of the issues currently associated with the financing of graduate medical education as matters of public policy.
住院医师支持资金的来源、教育活动的教师薪酬融资，以及有利于住院环境中所提供护理的报销偏向。利用1979年医院调查的数据，我们估计住院医师津贴和附加福利的总支出近16亿美元。这些资金的87%来自患者护理收入。教育活动的教师薪酬使毕业后医学教育成本又增加了3.76亿美元。教学医院住院护理收费的81%得到了收取，但门诊护理收费仅收取了72.8%。然而，医疗保险和医疗补助在这两种情况下报销的费用比例大致相同。文章最后指出，支付教学医院的统一收费系统将消除目前作为公共政策问题与毕业后医学教育融资相关的大多数问题。
