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Clinical and Community-Service Activities of Psychiatric Teaching Hospitals

From the University of North Carolina at Chapel Hill (UNC-CH) and the Malcolm Wiener Center for Social Policy, John F. Kennedy School of Government, Harvard University, Boston, Massachusetts. Address correspondence and reprint requests to Dr. Stroup, Campus Box 7160, Department of Psychiatry, UNC-CH, Chapel Hill, NC 27599–7160.

Because funding for teaching hospitals is threatened in the cost-conscious era of managed care, teaching hospitals must demonstrate their value. To examine the clinical and community-service activities of teaching hospitals, this study compared academic medical centers (AMCs) and other hospitals operating psychiatric residency programs with nonteaching hospitals. Data for the study are from the National Mental Health Facilities Survey, a national survey of providers of inpatient psychiatric care in the United States conducted at the beginning of the current managed care era. When compared with nonteaching hospitals, both types of teaching hospitals offered a larger number of specialized services and had a higher psychiatrist-to-patient ratio. The AMCs received a higher proportion of their revenues from Medicaid than did the nonteaching hospitals. Other teaching hospitals collected a lower percentage of their inpatient charges than the nonteaching hospitals. This study supports the notion that psychiatric teaching hospitals provided more care to low-income and underinsured persons than the nonteaching hospitals and that they offer more services and more psychiatric oversight. The authors find justification for supporting psychiatric teaching hospitals for their clinical and community-service activities.

Key Words: Teaching Hospitals • Academic Medical Centers • Clinical Activities

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