OTHER FACTORS
Bed size is included in the model recognizing that charges might be higher and length of stay longer for the selected clinical conditions due to the overhead costs and greater degree of teaching activity frequently associated with larger-size hospitals. Also, implementing quality improvement efforts may be more difficult in larger-size hospitals due to the higher number of organizational levels and greater complexity of operation.
METHODS
SAMPLE
Sixty-one of sixty-seven hospitals affiliated with the Western Network' s Center for Health Management Research participated in the study. Fifty-eight of the hospitals belonged to systems and the remaining three were freestanding independent hospitals.
Thirty-five percent of the hospitals are teaching hospitals (national average, 18 percent); 23 percent have a medical school affiliation (national average, 10 percent); and 8 percent are members of the Council of Teaching Hospitals (national average, 6 percent). Average bed size was 223 compared with 181 nationally. The average occupancy rate was 55 percent compared with 65 percent nationally. Thus, while the sample is not randomly selected, it is generally comparable to hospitals nationally with regard to bed size and occupancy rate, and more involved, at the same time, in teaching activities than hospitals are nationally.