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Risk of Death After Surgery Lower at Teaching Hospitals

Benefit not observed in black patients

TUESDAY, Feb. 17 (HealthDay News) -- Patients receiving surgery at major teaching hospitals are less likely to die and less likely to die after complications, although this finding is not observed among black patients, according to a report in the February issue of the Archives of Surgery.

Jeffrey H. Silber, M.D., Ph.D., from the Children's Hospital of Philadelphia, and colleagues retrospectively examined patient outcomes based on the teaching intensity of the hospital using data from 3,270 acute care hospitals in the United States, comprising Medicare claims for 4,658,954 patients. Of those, 109 hospitals were classified as very major teaching hospitals involving 240,489 patients.

Compared with patients at non-teaching hospitals, the researchers found that patients at very major teaching hospitals had a significant 15 percent lower risk of death and a significant 15 percent lower risk of death after complications (failure to rescue). There was no difference in the number of complications. Although black patients receive a disproportionate amount of care at teaching-intensive hospitals, the authors note, black patients had a similar likelihood of death and failure to rescue at teaching and non-teaching hospitals.

"Survival after surgery is higher at hospitals with higher teaching intensity," Silber and colleagues conclude. "Improved survival is because of lower mortality after complications (better failure to rescue) and generally not because of fewer complications. However, this better survival and failure to rescue at teaching-intensive hospitals is seen for white patients, not for black patients."

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