Mulhausen R, Kaemmerer C, Foley J, Schultz A
Minneapolis Veterans Administration Medical Center, Minneapolis, MN 55417.
Acad Med. 1989 Jun;64(6):314-9. doi: 10.1097/00001888-198906000-00007.
The authors examined the impact of costs of education on the overall expenses of two major teaching hospitals during a period of rapid growth and change in the Minneapolis and St. Paul, Minnesota, health care environment. By using a retrospective faculty-time study and the two hospitals' estimated costs for education, education costs of each hospital were compared--within and across facilities--with annual hospital operating expenses, with inflation, and by educational program. Unit costs were estimated for undergraduate and graduate medical students. Over the study period, allocated education costs averaged 13-14% of the hospitals' operating budgets. The combined mean allocated cost per medical student and resident was approximately +73,000 in 1983-84. During this period, allocated education costs were in line with medical inflationary trends and did not drive hospital expense increases. These findings suggest that policymakers wishing to restrain the rise in health care costs should look beyond cutting the costs of education programs and find other solutions.
作者们研究了在明尼阿波利斯和明尼苏达州圣保罗市医疗保健环境快速增长和变化的时期，教育成本对两家主要教学医院总体费用的影响。通过进行回顾性教员时间研究以及利用两家医院的教育估计成本，对每家医院的教育成本进行了比较——在各机构内部以及跨机构比较——与医院年度运营费用、通货膨胀情况以及按教育项目进行比较。估算了本科和研究生医学生的单位成本。在研究期间，分配的教育成本平均占医院运营预算的13 - 14%。1983 - 1984年，每名医学生和住院医师的分配成本合并平均约为73,000美元。在此期间，分配的教育成本与医疗通胀趋势一致，并未推动医院费用增加。这些发现表明，希望抑制医疗保健成本上升的政策制定者不应仅仅着眼于削减教育项目成本，而应寻找其他解决方案。
