The cost and funding of family practice graduate education in the United States.

This paper reports the findings of a national cost survey of 369 nonmilitary family practice graduate education programs in the United States, 1981-82. The purpose of the study was to develop a reliable revenue and cost information data base to enable an understanding of current family practice education costs and funding. The availability of this information will be of assistance in the development of future budgetary plans for family practice graduate education. The results presented are based on 147 programs associated with hospitals using a non-cost center accounting protocol. These programs provided 100 percent complete revenue and cost data (40 percent of the targeted programs). Major sources of income were hospital support (35 percent), patient income (31 percent), and public dollars (28 percent). The mean cost per accredited position was $57,471. Expenses, each at approximately one third of the total, were resident stipends, faculty salaries, and clinic expenses. Statistically significant differences were found only for source of income when program structure, program size, and geographic location were examined. Recommendations for future family practice funding include modification of present reimbursement formulas and other third-party payment mechanisms, increasing hospital support, maintenance of public subsidies, and development of a uniform system of monitoring and evaluating costs of residency programs operated under both cost center and non-cost center accounting protocols.