Financing graduate medical education. 1979

R M Knapp, and P W Butler

The direct costs of residency training in the United States are over $1 billion per year. These educational programs have been organized predominantly around hospital services and supported by hospital revenues. Pressure has been increasing to reduce the rate of increase in hospital expenditures or costs or both. This article describes alternative methods for financing graduate medical education. Debate over the current sources of financing reveals several troublesome issues: the presence of residents allegedly decreases the productivity of professionals and leads to overusage of ancillary services, proposed methods to pay for faculty salaries and services have created confusion and concern, and the financing of ambulatory-care training has been insufficient and poorly coordinated. The medical-education community must resolve these professional and educational problems so that financing issues can be debated and properly defended.

UI MeSH Term Description Entries
D007396 Internship and Residency Programs of EDUCATION, MEDICAL, GRADUATE training to meet the requirements established by accrediting authorities. House Staff,Internship, Dental,Residency, Dental,Residency, Medical,Dental Internship,Dental Internships,Dental Residencies,Dental Residency,Internship,Internship, Medical,Internships, Dental,Medical Residencies,Medical Residency,Residencies, Dental,Residencies, Medical,Residency,Residency and Internship,Internships, Medical,Medical Internship,Medical Internships,Residencies,Staff, House
D008505 Medical Staff, Hospital Professional medical personnel approved to provide care to patients in a hospital. Attending Physicians, Hospital,Hospital Medical Staff,Physicians, Junior,Registrars, Hospital,Attending Physician, Hospital,Hospital Attending Physician,Hospital Attending Physicians,Hospital Medical Staffs,Medical Staffs, Hospital,Hospital Registrar,Hospital Registrars,Junior Physician,Junior Physicians,Physician, Junior,Registrar, Hospital,Staff, Hospital Medical,Staffs, Hospital Medical
D011320 Primary Health Care Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192) Primary Care,Primary Healthcare,Care, Primary,Care, Primary Health,Health Care, Primary,Healthcare, Primary
D012051 Reimbursement Mechanisms Processes or methods of reimbursement for services rendered or equipment. Mechanism, Reimbursement,Mechanisms, Reimbursement,Reimbursement Mechanism
D003363 Cost Control The containment, regulation, or restraint of costs. Costs are said to be contained when the value of resources committed to an activity is not considered excessive. This determination is frequently subjective and dependent upon the specific geographic area of the activity being measured. (From Dictionary of Health Services Management, 2d ed) Cost Containment,Containment, Cost,Containments, Cost,Control, Cost,Controls, Cost,Cost Containments,Cost Controls
D003365 Costs and Cost Analysis Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs. Affordability,Analysis, Cost,Cost,Cost Analysis,Cost Comparison,Cost Measures,Cost-Minimization Analysis,Costs and Cost Analyses,Costs, Cost Analysis,Pricing,Affordabilities,Analyses, Cost,Analyses, Cost-Minimization,Analysis, Cost-Minimization,Comparison, Cost,Comparisons, Cost,Cost Analyses,Cost Comparisons,Cost Measure,Cost Minimization Analysis,Cost, Cost Analysis,Cost-Minimization Analyses,Costs,Measure, Cost,Measures, Cost
D004469 Economics, Hospital Economic aspects related to the management and operation of a hospital. Hospital Economics,Economic, Hospital,Hospital Economic
D004503 Education, Medical, Graduate Educational programs for medical graduates entering a specialty. They include formal specialty training as well as academic work in the clinical and basic medical sciences, and may lead to board certification or an advanced medical degree. Medical Education, Graduate,Education, Graduate Medical,Graduate Medical Education
D005180 Faculty, Medical Teaching and administrative staff having academic rank in a medical school. Faculties, Medical,Medical Faculties,Medical Faculty
D005380 Financing, Government Federal, state, or local government organized methods of financial assistance. Federal Aid,Financing, Public,Grants and Subsidies, Government,Hill-Burton Act,Subsidies, Government,Government Financing,Act, Hill-Burton,Aid, Federal,Aids, Federal,Federal Aids,Government Subsidies,Government Subsidy,Hill Burton Act,Public Financing,Subsidy, Government

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