Academic health science centers play a leading role in the development of new knowledge,1 yet the quality of care in academic hospitals is on average only modestly better than that of care provided by community hospitals.2 However, averages are also misleading. In one study evaluating care of patients with acute coronary syndrome, 15 of the 20 top-performing institutions were community hospitals.3 Indeed, many organizations that have been at the forefront of the quality improvement movement, such as Intermountain Healthcare and Geisinger Health System, are not among the highest-ranked academic centers in terms of research grants and research productivity.
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