Abstract
Hospitals that provide post-graduate medical education have a unique role in the American healthcare system. These hospitals provide a large portion of healthcare for populations that are poor and chronically ill. With few exceptions, these institutions are responsible for training all physicians who practice in the United States. Teaching hospitals receive funding for providing graduate medical education through the Medicare program, Medicaid program, Health and Human Services, the Veterans Administration, Department of Defense, and private funding from individual hospitals. Payment for training of postgraduate physicians consists of direct costs for maintaining residency training programs and indirect medical expenses related to the increased costs associated with having residency training programs in a hospital. Funding for individual residency training programs is determined by complex formulas which are reviewed.
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References
American Hospital Association website, http://www.aha.org/aha/resource-center/Statistics-and-Studies/fast-facts.html accessed April 5, 2009
http://www.acgme.org/acWebsite/meetings/THCGME/ReviewCommitteeStructureandResponsibilities.pdf accessed July 7,2011.
http://www.acgme.org/adspublic/ accessed July 18, 2011
Kastor, J Governance of Teaching Hospitals, Turmoil at Penn and Hopkins, Baltimore: Johns Hopkins University Press, 2003
Wynn B, Guarino C, Morse L, Cho M. Working Paper: Alternative Ways of Financing Graduate Medical Education. “2006, Office of the Secretary of Planning and Evaluation at the Department of Health and Human Services. Paper sponsored by the Rand Health.
http://opportunities.osteopathic.org/index.htm accessed July 28,2011
Freeman E, Lischka TA Osteopathic Graduate Medical Education JAOA Vol 109 #3 March 2009 pages 135–145.
Donabedian, A. (2005), Evaluating the Quality of Medical Care. Milbank Quarterly, 83: 691–729. doi: 10.1111/j.1468-0009.2005.00397.x
Health Care Financing Administration. “Medicare: A brief summary, “Available at http://www.hcfa.gov/medicare/ormedmed.htm #medicare
Knapp R. Complexity and uncertainty in financing graduate medical education. Acad Med. 2002;77(11):1076–1083
AAMC brochure. “Medicare Payment for GME: What Every Medical Student, Resident, and Advisor Needs to Know” Available at http://www.aamc.org/advocacy/library/gme/dgmebroc.pdf
Young JQ, Coffman JM. “Overview of Graduate Medical Education Funding Steams, Policy Problems, and Options for Reform.” West J Med 1998;168:428–436
American Academy of Family Physicians, summer 2007 Policy and Advocacy Statement. Available at http://www.aafp.org/online/en/home/policy/federal/background-on-federal-issues/medicled/html
www.coe.iup.edu/als/ALS_andouts/Cathleen_Wierzbowski_dissertation.doc accessed August 2, 2011
Sinay, T Cost structure of osteopathic hospitals and their local counterparts in the USA: Are they any different? Social Science & Medicine Volume 60, Issue 8, April 2005, Pages 1805–1814
Alliance for Academic Internal Medicine Task Force on Financing Medical Education. “APM: Why Medicare support Graduate Medical Education,” Amer J Med 2000;109(6):516–521.
Fifteenth Report of Council on Graduate Medical Education
Grover A, Oliver T, Lee P. “ State Variations in Medicare’s Graduate Medical Education Funding” Abstr Acad Health Policy Meet. 2000;17
Phillips RL et al. “The Balanced Budget Act of 1997 and the Financial Health of Teaching Hospitals,” Annals of Family Med 2004; 2(1):71
Chen FM, et al. “Accounting for Graduate Medical Education Funding in Family Practice Training,” Fam Med 2002;34(9):663–668.
Bruccoleri RE and Hexom BJ. “Graduate Medical Education Funding,” American Medical Student Association, www.amsa.org, accessed October 26, 2007.
Taylor DH, Whellan DJ, Sloan FA. “Effect of Admission to a Teaching Hospital on the Cost and Quality of Care of Medicare Beneficiaries.” NEJM 1999; 293–299
Report to the Congress by Medicare Payment Advisory Commission, Chairman G. Hackbarth. “Medicare Payment Policy.” March 2005. accessed April 5, 2009 http://www.medpac.gov/documents/Mar05_EntireReport.pdf
Young JQ, Coffman JM. “Overview on Graduate Medical Education Funding Streams, Policy Problems, and Options for Reform.” West J Med 1998; 168:428–436.
Krist AH, et al. “Title VII Funding and Physician Practice in Rural of Low-Income Areas.” Journal of Rural Health 2005; 21: 3–11
ACP position paper. The Physician Workforce and Financing of Graduate Medical Education 15 January 1998 Volume 128 Issue 2 pages 142–148 also found at: http://www.annals.org/cgi/content/full/128/2/142 accessed April 5, 2009
Snyderman R. Sheldon GF, Bischoff TA. “Gauging Supply and Demand: The Challenging Quest to Predict the Future Physician Workforce.” Health Affairs 2002; 21: 167–168
Petersdorf RG and Gorlein L. “The Future of Internal Medicine.” Annals Intern Med 1993; 119: 1130–7
J. Silva, Jr. “Viewpoint: Burden of Debt Creates Scarcity of General Practitioners.” AAMC Reporter October 2004, available at www.aamc.org/newsroom/reporter/oct04/viewpoint.htm
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Cymet, T., Chow, R.D. The Funding of Graduate Medical Education in the American Healthcare System. Med.Sci.Educ. 21, 367–374 (2011). https://doi.org/10.1007/BF03341738
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DOI: https://doi.org/10.1007/BF03341738