Page 17 - MEH_Supplement_Nov-Dec_2012

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M I D D L E E A S T H E A L T H |
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in the next 10 years, after which many are
expected to retire.
The majority of Association of American
Medical Colleges (AAMC) member
teaching hospitals are located in urban
areas, where one finds the high rates of
poverty endemic in inner-city neighbour-
hoods, and the treatment they provide to
injured or ill Americans is disproportionate
to their numbers. Teaching hospitals
provide 41% of all hospital charity care, and
they provide about 25% of all Medicaid
hospitalisations.
John Fernandez, the chief executive of
the Massachusetts Eye and Ear hospital,
is quoted in a recent press report as
saying the role that teaching hospitals
play in America's healthcare system has
never been more important. The US is
the global leader in medical care and life
science research and the foundation of
this advancement is its teaching hospi-
tals.
And it places value on partnerships;
through joining up with local community
organisations and local government agen-
cies. Greater Boston teaching hospitals, for
example, dedicated more than US$186
million to community benefit programmes,
said Fernandez, writing in the
Boston
Business Journal
earlier this this year.
It is clear that AAMC-member
teaching hospitals are more likely than
non-teaching hospitals to reach out to the
communities within which they are based.
For example, 89% of AAMC-member
teaching hospitals offer services to HIV
and AIDS sufferers, compared to 16% of
non-teaching hospitals. They also support
poison
control
centres,
nutrition
programmes, substance abuse outpatient
services
and
crisis
prevention
programmes.
And this … when teaching hospitals
represent only 6% of all hospitals in the
United States.
They also receive more than 40% of all
transferred patients. They provide 75%
of all burn care units, 62% of paediatric
intensive care units, 50% of surgical
transplant services, 41% of Alzheimer
centres, 40% of the nation’s neonatal
ICUs, 22% of cardiac surgery services,
often for the most seriously ill heart
patients, and 80% of specialised trauma
centres.
Research
Another important aspect of America’s
leadership in healthcare is its develop-
ment and use of advanced medical tech-
nology and pharmaceuticals. The research
and development of medical devices and
pharmaceuticals is supported by both
public and private sources of funding. In
2003, research and development expendi-
tures were approximately $95 billion with
$40 billion coming from public sources
and $55 billion coming from the private
sector. These investments into medical
research have made the United States the
leader in medical innovation, measured
either in terms of revenue or the number
of new drugs and devices introduced. In
2006, the United States accounted for
three quarters of the world’s biotech-
nology revenues and 82% of world R&D
spending in biotechnology, according to
figures from the European Federation of
Pharmaceutical Industries.
Healthcare spend
The US spends the most on healthcare
compared to all other countries. In 2009,
the United States federal, state and local
governments, corporations and individ-
uals, together spent a whopping $2.5 tril-
lion, or $8,047 per person, on health care,
according to figures from the Office of the
Actuary (OACT) of the Centers for
Medicare and Medicaid Services. This
equates to 17.3% of GDP, up from 16.2%
in 2008. According to the Congressional
Budget Office: “About half of all growth
in healthcare spending in the past several
decades was associated with changes in
medical care made possible by advances in
technology.” Other factors included
higher income levels, changes in insur-
ance coverage, and rising prices.
However, an analysis of the 2008 and
2009 data by Agency for Healthcare
Research and Quality (AHRQ) shows
that healthcare spending in the United
States is concentrated. The AHRQ found
that the 1% of the population with the
highest spending accounted for 27% of
aggregate healthcare spending. The
The role that teaching
hospitals play in America's
healthcare system has
never been more impor-
tant. The US is the global
leader in medical care and
life science research and
the foundation of this
advancement is its
teaching hospitals.