Garg M L, Elkhatib M, Kleinberg W M, Mulligan J L
Med Care. 1982 Jul;20(7):719-26. doi: 10.1097/00005650-198207000-00007.
Through an investigation of charges generated for 105 patients treated for congestive heart failure, three issues of reimbursement policy for graduate medical education are examined: 1) reimbursement policy by third parties for resident salaries and for the portion of teaching physicians' time devoted to graduate medical education; 2) the level of involvement for physicians in dual roles as attending physicians for private patients when simultaneously engaged in graduate medical education and supervising patient care delivered by residents; and 3) the greater utilization of hospital resources in teaching units. The results demonstrate that the reimbursement policy, as presently practiced, ignores the basic differences in the level of involvement between teaching and nonteaching physicians. The data also show for the first time the incremental effect of graduate medical education in a teaching hospital. Several alternatives are suggested to eliminate the deficiencies.
通过对105名充血性心力衰竭患者的收费情况进行调查，研究了毕业后医学教育报销政策的三个问题：1）第三方对住院医师工资以及教学医师用于毕业后医学教育的那部分时间的报销政策；2）医师在作为私人患者的主治医师同时参与毕业后医学教育并监督住院医师提供的患者护理时的参与程度；3）教学单位对医院资源的更多利用。结果表明，目前实行的报销政策忽视了教学医师和非教学医师参与程度的基本差异。数据还首次显示了教学医院毕业后医学教育的增量效应。提出了几种替代方案以消除这些不足。
