What educational costs are deductible?
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One of the less obvious costs of educational programs is the increased volume of work-ups and treatment for hospitalized patients that are ordered by residents. In a hospital which has both private teaching and private nonteaching floors, a comparison of these costs shows that service charges on teaching floors are 60 percent higher than on nonteaching floors. The sicker the patients are, the greater is the disparity.
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Costs of nursing education and practice, usually seen as separate spheres, are in fact interrelated. This article describes cost models and policy implications for their use, nursing education costs to universities and students, and benefits and costs to clinical service agencies.
Medicare's support of graduate medical education includes funds allocated to the direct costs of graduate medical education: housestaff stipends and benefits, faculty costs, and related educational costs such as classroom space. As reimbursed through the mechanism called the direct graduate medical education (DGME) pass-through, these direct costs have been reported to vary widely from one teaching hospital to another, with little explanation for this variation being available. Based on a national survey of 69 teaching hospitals--principally affiliated community teaching hospitals--the author suggests that a major cause for the variation in these costs might be found in their faculty-expenses component. It is further suggested that economies of scale may provide some clue as to the variability of these costs. The author also reports lower DGME costs for the survey sample than for the national sample, and suggests that the fact that community teaching hospital faculties include a significant volunteer component may account for some of these savings.
In an effort to attract critical care staff to hospitals and defray education costs, many hospitals are asking educators to market critical care programming to the nursing community. A lack of marketing and business skills may make this task seem more overwhelming than it actually is. Steps in marketing are discussed and suggestions for marketing critical care education programs are offered.
Minimal attention has been given to targeting men as a source of nursing school applicants. In this study, a survey was conducted of all U.S. baccalaureate programs accredited by the NLN. School variables and recruitment strategies related to male application and enrollment rates were identified. Consisting of 5.3% of the average school enrollment rate, men remain a minority in nursing schools. Twelve percent of the schools reported no men enrolled in their programs. Seventy percent of the schools reported no effort to recruit men. Schools with higher male application and enrollment rates had lower educational costs, more male faculty, more doctorally prepared faculty, larger gift and endowment funds, and provided expense paid visits to the campus for high school personnel. Only a few isolated schools recruited men into their programs with success.
A private group practice and a traditional hospital medical clinic are joined together as a teaching group practice for primary care (Internal Medical Associates). Responsible for revenues as well as costs, the practice is administered by a board of managers composed of physicians, nurses, and administrators in the practice. This decentralization of practice from the clinical department and hospital administration has resulted in (1) a reduction in the numbers of physicians needed for the practice, (2) a greater visit census with increased physician productivity, and (3) a reduced operating deficit and better understanding of transient and educational costs. The matrix organization of the board of managers has resulted in better communication and a commitment of the staff to common goals. Public demand for a single standard of care for patients of all backgrounds, professional aspirations to work in groups, and educators' interest in training outside the hospital converge to make such reorganizations of practical necessity.
Reluctance to train women for medical careers has been justified by the failure of women to use their education. Using data from studies of physician practice patterns and of educational costs, this article presents a preliminary estimate of the "loss" of investment involved in educating women for medicine. Women physicians are estimated to practice an average of two-fifths fewer hours over their lifetimes than do men, with a consequent loss of educational investment of about $55,000. Suggestions are made for reducing this loss. The finding of some loss of investment should not be used as an argument for discriminatory treatment of women seeking a medical education, as the rights of women as individuals must be recognized.
Over the past 7 years, the cost of tuition and residence fees at the University of Cape Town Medical School has risen by 21.75% each year. This is considerably higher than the increase in the consumer price index over the same period and students are increasingly having to resort to loans to finance their education. The starting salary of a medical officer in the state services has, however, only risen by 9.73% each year over the same period. If these trends continue, the likelihood of young medical doctors employed in such posts being able to repay their loans is bleak and the services will experience increasing difficulty in filling posts, particularly in the peri-urban and rural areas. An innovative manner of financing medical education is needed. This could include allowing education costs to be tax-deductible after graduation, or providing incentives, rather than using coercion, to encourage young doctors to settle in less popular locations.
This paper reports the results of a 1985 survey of certificate/associate degree students' interest in advanced education: baccalaureate degree completion and non-degree granting residency programs. Subjects included first- and second-year dental hygiene students enrolled in 12 vocational, community college, state, and research university institutions in a five-state region in the upper Midwest. The data collection instrument consisted of a 12-item mailed questionnaire. One hundred percent program and 78.7% student response rates were achieved. Results indicate that respondents are interested in degree completion and non-degree granting residency programs. Interest varied by age and by type of institution in which respondents were completing their dental hygiene education. While younger respondents were more likely to express interest in advanced education, respondents over the age of 30 were generally interested or undecided. Overall, respondents indicated slightly different areas of interest for degree completion versus residency programs. In general, respondents indicated an interest in pursuing advanced education on a part-time, evening basis, within five years of completion of their basic dental hygiene education. Cost, time, and family commitments were identified by respondents as major barriers to continuing their education.
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