HOSPITALS: Study Shows State’s Academic Medical Centers Successfully Adapting To Managed Care

      Academic medical centers in California have responded to the pressures of managed care more effectively than community hospitals, according to a study presented yesterday at the 1998 Clinical Congress of the American College of Surgeons. Researchers at the University of California-San Francisco studied patient outcomes and treatment costs associated with complex abdominal surgical procedures as a telling comparison among the state's hospitals. They found that by the conclusion of the four-year study period (1990-94) -- a time when managed care was on the rise in California -- mortality rates for the procedures performed at teaching and research hospitals were one-fourth of those performed at community hospitals. Furthermore, patients receiving treatment in the research facilities had shorter recovery stays following the procedures than those treated at community hospitals -- 12.8 days vs. 15.1 days. UCSF researchers also found that patients treated in academic medical centers had fewer complications stemming from the procedures, as measured by a smaller percentage of patients with recovery stays of longer than 20 days. Only 19% of those patients undergoing surgery in academic medical centers had hospital stays extending over 20 days, while 28% of those receiving the procedure in community hospitals had longer than 20-day stays.

Academia Pulls Ahead"The data suggests that the academic medical center provides a service within the health care marketplace that is not matched by the average community hospital in terms of the outcomes of care following highly complex abdominal operations," said Sean Mulvihill, UCSF chief of general surgery. He asserted that the study results counter the perception that academic medical centers are poorly run and lack cost-efficient strategies. He said, "Not only does the academic medical center accomplish the teaching mission that society needs but this study shows it also delivers care in an efficient manner" (UCSF release, 10/28).