Funding for the colleges of medicine: integrated delivery systems to the rescue.
Year: 1996
Type: article
Abstract: In 1995 colleges of medicine, as part of academic health centers, face major threats of decreases in funding from all their traditional sources. In the past four decades, academic health centers have built themselves into national and regional resources based upon multiple funding streams. The growth in the budgets of their colleges of medicine has been phenomenal, with increases in revenues from $889 million in 1960 to a projected figure of more than $25 billion in 1995 (1). These large revenues are from multiple sources but largely come from research and patient care revenues; however, they are necessary for the survival of the academic health centers as we know them (2-3). Support of undergraduate medical education is only a small part of the overall costs of colleges of medicine. Thus, it is not surprising that only a small fraction of the total college revenues comes from tuition, at both public and private colleges, or subsidies, as is the case with state-supported colleges of medicine (4). However, the true costs of undergraduate medical education are not known, but are now under intense study (5,6). In the past, it has been assumed that much of the educational costs have been borne by a cost shifting (5). In the 1960's and '70's research revenues paid for faculty and resources that provided much of the teaching in colleges of medicine. Numerous rationales were developed to justify this form of cost shifting. In the 1980's and '90's, the funding of faculty and other costs of undergraduate education and unfunded research became more dependent on surplus revenues from clinical care provided by faculty practice plans and with the transfer of revenues from hospitals. Cost shifting of these funds to pay the educational costs has permitted the massive growth of the medical faculty, especially in clinical departments. While research funds have continued to increase, and the NIH expenditures in 1995 will exceed $12 billion, they have not kept pace
Source: PubMed Central
Authors: D C Harrison, J J Hutton, J R Hillard
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W180033112