Hospital Teaching Status and Medicare Expenditures for Complex Surgery (original) (raw)

Background The association of hospital teaching status and overall expenditures has not been studied among patients undergoing hepato-pancreato-biliary (HPB) surgery. We sought to define the impact of hospital teaching intensity on payments and charges associated with (HPB) surgery from the payer perspective. Methods Surgical patients undergoing HPB procedures were identified using 2013-2015 Medicare Provider Analysis and Review (MEDPAR) data. Hospital teaching intensity was categorized based on hospital resident-to-bed ratio: nonteaching (NTH: 0), minor teaching (minor-TH: 0-0.363), and major teaching (major-TH: [ 0.363). Risk-adjusted pricestandardized Medicare payments were assessed and compared among HPB surgical patients at NTH versus major-TH. Results A total of 8863 patients underwent HPB (NTH: n = 1239, 14.0%; minor-TH: n = 3202, 36.1%; major-TH: n = 4422, 49.9%). Patient comorbidities did not vary across hospital according to teaching intensity (p = 0.27