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Teaching Hospitals and Quality of Care: A Review of the Literature

Teaching hospitals are widely perceived to provide high-quality care, and that reputation is thought to justify these institutions' comparatively higher charges relative to nonteaching hospitals. Despite their reputation for specialized care, teaching hospitals have traditionally relied on revenue from routine services, such as treatment of heart disease, pneumonia, and stroke, to subsidize the costs of specialized services and medical training. However, with managed care and competition creating pressures for cost containment, these higher costs have come into question. Do teaching hospitals provide higher-quality care for such routine services, or do nonteaching hospitals provide comparable quality at lower costs?

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"Teaching Hospitals and Quality of Care: A Review of the Literature," John Z. Ayanian and Joel S. Weissman, The Milbank Quarterly 80, 3 (September 2002)