Dataset Information

A Comparison of Laboratory Testing in Teaching vs Nonteaching Hospitals for 2 Common Medical Conditions.

ABSTRACT:

Importance

Robust laboratory use data are lacking to support the general assumption that teaching hospitals with trainees routinely order more laboratory tests for inpatients than do nonteaching hospitals.

Objective

To quantify differences in the use of laboratory tests between teaching and nonteaching hospitals.

Design, setting, and participants

A cross-sectional study was performed using a statewide database to identify hospitalizations with a primary diagnosis of bacterial pneumonia or cellulitis from January 1, 2014, to June 30, 2015, at teaching and nonteaching hospitals with 100 or more hospitalizations of each condition. Patients included were adult inpatients with a primary diagnosis of bacterial pneumonia (n?=?24?118) or cellulitis (n?=?19?211); patients excluded were those with an intensive care unit stay, transfer from another hospital, or a length of stay that was 2 SDs or more of the condition's mean length of stay.

Main outcomes and measures

Mean laboratory tests per day stratified by illness severity, as well as factors associated with laboratory use rates.

Results

A total of 43?329 hospitalized patients (20493 women and 22836 men) had a principal diagnosis of bacterial pneumonia or cellulitis across 11 major teaching hospitals, 12 minor teaching hospitals, and 73 nonteaching hospitals in Texas. Mean number of laboratory tests per day varied significantly by hospital type and was highest for major teaching hospitals for both conditions (bacterial pneumonia: major teaching hospitals, 13.21; 95% CI, 12.91-13.51; nonteaching hospitals, 8.92; 95% CI, 8.84-9.00; P?Conclusions and relevanceCompared with nonteaching hospitals, patients in Texas admitted to major teaching hospitals with bacterial pneumonia or cellulitis received significantly more laboratory tests after controlling for illness severity, length of stay, and patient demographics. These results support the need to examine how the culture of training environments may contribute to increased use of laboratory tests.

SUBMITTER: Valencia V

PROVIDER: S-EPMC5833503 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature

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Publications

A Comparison of Laboratory Testing in Teaching vs Nonteaching Hospitals for 2 Common Medical Conditions.

Valencia Victoria V Arora Vineet M VM Ranji Sumant R SR Meza Carlos C Moriates Christopher C

JAMA internal medicine 20180101 1

<h4>Importance</h4>Robust laboratory use data are lacking to support the general assumption that teaching hospitals with trainees routinely order more laboratory tests for inpatients than do nonteaching hospitals.<h4>Objective</h4>To quantify differences in the use of laboratory tests between teaching and nonteaching hospitals.<h4>Design, setting, and participants</h4>A cross-sectional study was performed using a statewide database to identify hospitalizations with a primary diagnosis of bacteri ...[more]

PMID: 29131899

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Project description:Background: There is general consensus that the organizational and administrative aspects of academic study programs exert an important influence on teaching and learning. Despite this, no comprehensive framework currently exists to describe the conditions that affect the quality of teaching and learning in medical education. The aim of this paper is to systematically and comprehensively identify these factors to offer academic administrators and decision makers interested in improving teaching a theory-based and, to an extent, empirically founded framework on the basis of which improvements in teaching quality can be identified and implemented. Method: Primarily, the issue was addressed by combining a theory-driven deductive approach with an experience based, "best evidence" one during the course of two workshops held by the GMA Committee on Personnel and Organizational Development in Academic Teaching (POiL) in Munich (2013) and Frankfurt (2014). Two models describing the conditions relevant to teaching and learning (Euler/Hahn and Rindermann) were critically appraised and synthesized into a new third model. Practical examples of teaching strategies that promote or hinder learning were compiled and added to the categories of this model and, to the extent possible, supported with empirical evidence. Based on this, a checklist with recommendations for optimizing general academic conditions was formulated. Results: The Frankfurt Model of conditions to ensure Quality in Teaching and Learning covers six categories: organizational structure/medical school culture, regulatory frameworks, curricular requirements, time constraints, material and personnel resources, and qualification of teaching staff. These categories have been supplemented by the interests, motives and abilities of the actual teachers and students in this particular setting. The categories of this model provide the structure for a checklist in which recommendations for optimizing teaching are given. Conclusions: The checklist derived from the Frankfurt Model for ensuring quality in teaching and learning can be used for quality assurance and to improve the conditions under which teaching and learning take place in medical schools.

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Dataset Information

A Comparison of Laboratory Testing in Teaching vs Nonteaching Hospitals for 2 Common Medical Conditions.

Importance

Objective

Design, setting, and participants

Main outcomes and measures

Results

Publications

A Comparison of Laboratory Testing in Teaching vs Nonteaching Hospitals for 2 Common Medical Conditions.

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