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Costs and reimbursement of medical teaching and clinical research in Finland.

Alongside care and cure, hospitals produce teaching and research (T&R). In addition to the direct costs the T&R decrease productivity in patient care. An econometric model was used to estimate the effect of T&R. The variables in model were number of postgraduate medical students, on-the-job training weeks of nurses and the weighted number of articles published in scientific journals. Also service-mix (DRG), input mix and factor-prices were controlled. The average influence of teaching and research in costs of teaching hospitals was found to be 14.5 per cent. The cost of T&R in teaching hospitals varied between 10 and 16 per cent. The new reimbursement method based on the weighted numbers of physician examinations, dissertations and published articles in scientific journals was adopted. The total reimbursement was 700 million FIM per annum on which 50 per cent for the costs of research.