Skip to main content
Top
Published in: Journal of Community Health 2/2018

01-04-2018 | Original Paper

Is There a Return on a Children’s Hospital’s Investment in a Pediatric Residency’s Community Health Track? A Cost Analysis

Authors: Cara Lichtenstein, Denice Cora-Bramble, Mary Ottolini, Dewesh Agrawal

Published in: Journal of Community Health | Issue 2/2018

Login to get access

Abstract

Academic Medical Centers incur significant expenses associated with training residents and caring for underserved populations. No previous studies have analyzed hospital-level graduate medical education economics for pediatric residency training. Using data from the 2010–2011 academic year, we quantified total direct costs per year for training 12 community health track (CHT) residents. Utilizing sensitivity analyses, we estimated revenues generated by residents in inpatient and outpatient settings. The total yearly direct cost of training 12 CHT residents was $922,640 including salaries, benefits, and administrative costs. The estimated additional yearly inpatient net revenue from attending-resident clinical teams compared to attendingonly service was $109,452. For primary care clinics, the estimated yearly revenue differential of resident-preceptor teams was $455,940, compared to attending-only clinics. The replacement cost of 12 CHT residents with advanced practitioners was $457,596 per year.This study suggests there is positive return on a children’s hospital’s investment in a CHT.
Literature
1.
go back to reference Committee on Pediatric Workforce. (2008) Financing graduate medical education to meet the needs if children and the future pediatrician workforce. Pediatrics 121, 855–861.CrossRef Committee on Pediatric Workforce. (2008) Financing graduate medical education to meet the needs if children and the future pediatrician workforce. Pediatrics 121, 855–861.CrossRef
2.
go back to reference Grover, A., Slavin, P. L., & Willson, P. (2014). The economics of academic medical centers. New England Journal of Medicine, 370, 2360–2362.CrossRefPubMed Grover, A., Slavin, P. L., & Willson, P. (2014). The economics of academic medical centers. New England Journal of Medicine, 370, 2360–2362.CrossRefPubMed
4.
go back to reference Nuckols, T. K., Bhattacharya, J., Wolman, D. M., Ulmer, C., & Escarce, J. J. (2009). Cost implications of reduced work hours and workloads for resident physicians. New England Journal of Medicine, 360, 2202–2215.CrossRefPubMed Nuckols, T. K., Bhattacharya, J., Wolman, D. M., Ulmer, C., & Escarce, J. J. (2009). Cost implications of reduced work hours and workloads for resident physicians. New England Journal of Medicine, 360, 2202–2215.CrossRefPubMed
5.
go back to reference Romano, P. S., & Volpp, K. (2012). The ACGME’s 2011 changes to resident duty hours: Are they an unfunded mandate on teaching hospitals? Journal of general internal medicine: official journal of the Society for Research and Education in Primary Care Internal Medicine, 27, 136–138.CrossRef Romano, P. S., & Volpp, K. (2012). The ACGME’s 2011 changes to resident duty hours: Are they an unfunded mandate on teaching hospitals? Journal of general internal medicine: official journal of the Society for Research and Education in Primary Care Internal Medicine, 27, 136–138.CrossRef
6.
go back to reference APPD Board of Directors (2009) APPD position statement in response to the IOM recommendations on resident duty hours. Released April 30, 1–12. APPD Board of Directors (2009) APPD position statement in response to the IOM recommendations on resident duty hours. Released April 30, 1–12.
9.
go back to reference Petterson, S. M., Liaw, W. R., Phillips, R. L., Rabin, D. L., Meyers, D. S., & Bazemore, A. W. (2012). Projecting US primary care physician workforce needs: 2010–2025. Annals of Family Medicine, 10, 503–509.CrossRefPubMedPubMedCentral Petterson, S. M., Liaw, W. R., Phillips, R. L., Rabin, D. L., Meyers, D. S., & Bazemore, A. W. (2012). Projecting US primary care physician workforce needs: 2010–2025. Annals of Family Medicine, 10, 503–509.CrossRefPubMedPubMedCentral
10.
go back to reference Stimpson, J., Li, T., Shiyanbola, O., & Jackson, J. (2014). Financial sustainability of academic health centers: Identifying challenges and strategic responses. Academic Medicine, 89, 853–857.CrossRefPubMed Stimpson, J., Li, T., Shiyanbola, O., & Jackson, J. (2014). Financial sustainability of academic health centers: Identifying challenges and strategic responses. Academic Medicine, 89, 853–857.CrossRefPubMed
11.
go back to reference Franzini, L., Monteiro, F. M., Fowler, G. C., & Low, M. D. (1999). A cost construction model to assess the cost of a family practice residency program. Family Medicine, 31, 159–170.PubMed Franzini, L., Monteiro, F. M., Fowler, G. C., & Low, M. D. (1999). A cost construction model to assess the cost of a family practice residency program. Family Medicine, 31, 159–170.PubMed
12.
go back to reference Casey, L., Gillanders, W. R., & Oprandi, A. (1995). Economic analysis of family practice residency programs: A report for the Northeast Ohio Network. Family Medicine, 27, 7. Casey, L., Gillanders, W. R., & Oprandi, A. (1995). Economic analysis of family practice residency programs: A report for the Northeast Ohio Network. Family Medicine, 27, 7.
13.
go back to reference Zeidel, M. L., Kroboth, F., McDermot, S., et al. (2005). Estimating the cost to departments of medicine of training residents and fellows: A collaborative analysis. The American Journal of Medicine, 118, 557–564.CrossRefPubMed Zeidel, M. L., Kroboth, F., McDermot, S., et al. (2005). Estimating the cost to departments of medicine of training residents and fellows: A collaborative analysis. The American Journal of Medicine, 118, 557–564.CrossRefPubMed
14.
go back to reference Chandra, A., Khullar, D., & Wilensky, G. R. (2014). The Economics of Graduate Medical Education. New England Journal of Medicine, 370, 2357–2360.CrossRefPubMed Chandra, A., Khullar, D., & Wilensky, G. R. (2014). The Economics of Graduate Medical Education. New England Journal of Medicine, 370, 2357–2360.CrossRefPubMed
15.
go back to reference Iannuzzi, M. C., Iannuzzi, J. C., Holtsbery, A., Wright, S. M., & Knohl, S. J. (2015). Comparing hospitalist-midlevel practitioner team performance on length of stay and direct patient care cost. Journal of Graduate Medical Education, 7, 65–69.CrossRefPubMedPubMedCentral Iannuzzi, M. C., Iannuzzi, J. C., Holtsbery, A., Wright, S. M., & Knohl, S. J. (2015). Comparing hospitalist-midlevel practitioner team performance on length of stay and direct patient care cost. Journal of Graduate Medical Education, 7, 65–69.CrossRefPubMedPubMedCentral
16.
go back to reference Morris, C. G., Johnson, D., Kim, S., & Chen, F. M. (2008). Training family medicine residents in community health centers: a health workforce solution. Family Medicine, 40, 271–276.PubMed Morris, C. G., Johnson, D., Kim, S., & Chen, F. M. (2008). Training family medicine residents in community health centers: a health workforce solution. Family Medicine, 40, 271–276.PubMed
17.
go back to reference Jones, T. F., Culpepper, L., & Shea, C. (1995). Analysis of the cost of training residents in a community health center. Academic Medicine, 70, 523–531.CrossRefPubMed Jones, T. F., Culpepper, L., & Shea, C. (1995). Analysis of the cost of training residents in a community health center. Academic Medicine, 70, 523–531.CrossRefPubMed
18.
go back to reference Jones, T. F. (1997). The cost of outpatient training of residents in a community health center. Family Medicine, 29, 347–352.PubMed Jones, T. F. (1997). The cost of outpatient training of residents in a community health center. Family Medicine, 29, 347–352.PubMed
20.
go back to reference Nasca, T. J., Veloski, J. J., Monnier, J. A., et al. (2001). Minimum instructional and program specific administrative costs of educating residents in internal medicine. Archives of internal medicine, 161, 760–766.CrossRefPubMed Nasca, T. J., Veloski, J. J., Monnier, J. A., et al. (2001). Minimum instructional and program specific administrative costs of educating residents in internal medicine. Archives of internal medicine, 161, 760–766.CrossRefPubMed
21.
go back to reference Cora-Bramble, D., Joseph, J., Jain, S., Huang, Z. J., Gaughan-Chaplain, M., & Batshaw, M. (2006). A cross-cultural pediatric residency program merger. Academic medicine: journal of the Association of American Medical Colleges, 81, 1108–1114.CrossRef Cora-Bramble, D., Joseph, J., Jain, S., Huang, Z. J., Gaughan-Chaplain, M., & Batshaw, M. (2006). A cross-cultural pediatric residency program merger. Academic medicine: journal of the Association of American Medical Colleges, 81, 1108–1114.CrossRef
22.
go back to reference Morris, C. G., & Chen, F. M. (2009). Training residents in community health centers: Facilitators and barriers. Annals of Family Medicine, 7, 488–494.CrossRefPubMedPubMedCentral Morris, C. G., & Chen, F. M. (2009). Training residents in community health centers: Facilitators and barriers. Annals of Family Medicine, 7, 488–494.CrossRefPubMedPubMedCentral
Metadata
Title
Is There a Return on a Children’s Hospital’s Investment in a Pediatric Residency’s Community Health Track? A Cost Analysis
Authors
Cara Lichtenstein
Denice Cora-Bramble
Mary Ottolini
Dewesh Agrawal
Publication date
01-04-2018
Publisher
Springer US
Published in
Journal of Community Health / Issue 2/2018
Print ISSN: 0094-5145
Electronic ISSN: 1573-3610
DOI
https://doi.org/10.1007/s10900-017-0433-5

Other articles of this Issue 2/2018

Journal of Community Health 2/2018 Go to the issue