Franzini L, Low M D, Proll M A
University of Texas Health Science Center at Houston, USA.
Acad Med. 1997 Mar;72(3):228-37. doi: 10.1097/00001888-199703000-00018.
To assess the cost of educating undergraduate medical students at the University of Texas-Houston Medical School (UT-Houston) in 1994-95 through the use of a cost-construction model developed elsewhere and adapted for UT-Houston.
The cost-construction model identified the cost of the entire program as well as instructional costs (the cost of activities related to direct-contact teaching), educational costs (instructional costs plus the costs of general supervision), and milieu costs (educational costs plus the costs of research). The model predicted these costs based on student contact hours, student enrollment, full-time-equivalent (FTE) faculty and residents required, professional-activity profiles, faculty and resident salaries, and supporting resource costs. Sensitivity analysis was used to explore the effects of such factors as institutional overhead, joint products, volunteer faculty, residents, and varying assumptions about the percentage of time the faculty dedicated to direct-contact teaching.
The four-year undergraduate medical program at UT-Houston had a total cost of $82,692,280. For an average class of 200 students, the annual per-student instructional, educational, and milieu component costs were $43,993, $57,370, and $90,660, respectively. The program required 201 FTE faculty members and 258 FTE residents. Sensitivity analysis revealed the financial effects of the various factors, some of which increased costs and some of which decreased costs.
Although the cost-construction model is conceptually straightforward, there are several inherent complexities and aspects open to debate that must be understood in its application: for example, assumptions regarding faculty time; assumptions regarding the allocation of faculty time to various activities; the definition of those activities; the difficulty of separating costs; the difficulty of accurately defining total educational costs; and so on. However, this study provides a starting point for identifying the distinct costs associated with an undergraduate medical school program and should encourage further discussion and research.
通过使用在其他地方开发并适用于德克萨斯大学休斯顿医学院（UT - 休斯顿）的成本构建模型，评估1994 - 1995年该校本科医学生的教育成本。
成本构建模型确定了整个项目的成本以及教学成本（与直接接触教学相关活动的成本）、教育成本（教学成本加上一般监督成本）和环境成本（教育成本加上研究成本）。该模型根据学生接触时间、学生入学人数、所需的全职等效（FTE）教师和住院医师、专业活动概况、教师和住院医师薪资以及支持资源成本来预测这些成本。敏感性分析用于探讨诸如机构间接费用、联合产品、志愿教师、住院医师以及关于教师用于直接接触教学时间百分比的不同假设等因素的影响。
UT - 休斯顿的四年制本科医学项目总成本为82,692,280美元。对于平均每班200名学生，每年每名学生的教学、教育和环境组成部分成本分别为43,993美元、57,370美元和90,660美元。该项目需要201名FTE教师和258名FTE住院医师。敏感性分析揭示了各种因素的财务影响，其中一些因素增加了成本，一些因素降低了成本。
尽管成本构建模型在概念上很简单，但在其应用中存在几个固有的复杂性和有待辩论的方面必须加以理解：例如，关于教师时间的假设；关于教师时间分配到各种活动的假设；这些活动的定义；分离成本的困难；准确界定总教育成本的困难等等。然而，本研究为确定本科医学院项目的不同成本提供了一个起点，并应鼓励进一步的讨论和研究。
