Whither academic values during the transition from academic medical centers to integrated health delivery systems?

Da, Blake

doi:10.1097/00001888-199608000-00007

Cited by 8 publications

(1 citation statement)

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“…Academic health centers have traditionally relied on clinical revenue to help support core academic programs and biomedical research. 2,7 The largest share of this clinical support, estimated at $0.10 of every faculty practice plan dollar collected, was used to finance research. 8 In an increasingly competitive health care marketplace, AHCs have faced disproportionate economic pressures.…”

Section: Discussionmentioning

confidence: 99%

Academic Emergency Medicine Staffing Nonacademic Emergency Department Sites: A National Survey

Meldon

Cydulka

Jourıles

et al. 1999

Academic Emergency Medicine

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Abstract. Changing health care markets have threatened academic health centers and their traditional focus on teaching and research. Objectives: To determine the number of academic emergency medicine departments (AEMDs) that staff additional nonacademic ED sites and to determine whether clinical reimbursement monies from those ED sites are used for academic purposes. Methods: A two-part survey of all 119 academic EM programs listed in the 1997 -1998 Graduate Medical Education Directory was conducted. Questionnaires were addressed to each AEMD chair. AEMDs and ED sites were characterized. Hiring difficulties, EM faculty academic productivity, and use of ED site reimbursement monies for academic activities were assessed. Results: Ninety-nine of 119 (83%) AEMDs responded. Twentythree (23%) AEMDs staffed 28 added ED sites. These sites tended to be urban (65%), with moderate volumes (25,000 -35,000 patients/year), and had an equal or better reimbursement rate than the AEMD (89%). ED sites were commonly staffed by academic EM faculty (79%) and EM residents (29%). Ninety-six percent of the AEMDs had hired additional faculty; hiring new faculty was considered easy. Academic productivity at AEMDs with added ED sites was reported as unchanged. Reimbursement monies from these ED sites were commonly used for faculty salary support, faculty development, and EM research and residency activities. Conclusions: Academic EM departments are often affiliated with nonacademic ED sites. These additional sites are commonly staffed by academic EM faculty and EM residents. Academic productivity does not appear to decrease when additional ED sites are added. Reimbursement monies from these ED sites commonly supports academic activities. Key words: academic emergency medicine; clinical ED sites; academic productivity. ACADEMIC EMERGENCY MEDICINE 1999; 6:334 -338 T REMENDOUS change has occurred in the health care marketplace in the last decade. The growth of managed care and increased competition in local health care markets have resulted in an increased emphasis on clinical productivity and income. These changes have had a particular impact on academic health centers (AHCs).1 -3 The resulting cost consciousness, including pressures to downsize graduate medical education programs, has led to major changes in core academic values. The previous focus on teaching and research at AHCs has been replaced by attention to customer service and financial efficiency. These economic pressures may reduce AHCs' ability to cross-subsidize their teaching and research missions.5 Anecdotal evidence suggests that academic emergency medicine departments (AEMDs) are staffing nonacademic ED clinical sites in response to such economic pressures. We surveyed AEMDs to determine the prevalence of this practice and whether reimbursement monies from these nonacademic ED sites were used for academic purposes. METHODSStudy Design. A survey was conducted of all 119 allopathic EM residency programs listed in the 1997 -98 Graduate Medical Education Directory. 6Surveys ...

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Section: Discussionmentioning

confidence: 99%

Academic Emergency Medicine Staffing Nonacademic Emergency Department Sites: A National Survey

Meldon

Cydulka

Jourıles

et al. 1999

Academic Emergency Medicine

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Relationship Between National Institutes of Health Research Awards to US Medical Schools and Managed Care Market Penetration

Moy

Mazzaschi²,

Levin³

et al. 1997

JAMA

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Leveling the playing field: A report of the commonwealth fund task force on academic health centers

Blumenthal

Thier

1998

J Urban Health

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Over the last 50 years, the nation's academic health centers (AHCs)--defined here as the 125 institutions that include at least a medical school and its closely affiliated clinical facilities and faculty practice plans--have come to serve a unique set of functions in the nation's health care system and in their communities. The AHCs produce a variety of health-related goods and services that have social value, but tend to be undervalued and undersupplied in competitive markets.These goods and services include basic and clinical research, the training of health professionals, certain highly specialized clinical services, and continuous innovation in health care services. In the balance of this paper, we refer to these functions as the "social missions" of AHCs. (Though some AHCs, especially the publicly owned centers, also consider care for the indigent a vital social mission, not all AHCs are disproportionate providers of indigent care. Therefore, this paper does not deal specifically with the indigent care mission of AHCs.)A number of commentators 1-3 have suggested that the evolution of the US health care system into a more market-competitive system could have dramatic consequences for the ability of AHCs to discharge their social missions. Providing these goods and services requires resources. Until recently, AHCs and other teaching institutions financed a significant proportion of these costs through From Partners

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Whither academic values during the transition from academic medical centers to integrated health delivery systems?

Cited by 8 publications

References 0 publications

Academic Emergency Medicine Staffing Nonacademic Emergency Department Sites: A National Survey

Academic Emergency Medicine Staffing Nonacademic Emergency Department Sites: A National Survey

Relationship Between National Institutes of Health Research Awards to US Medical Schools and Managed Care Market Penetration

Leveling the playing field: A report of the commonwealth fund task force on academic health centers

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