A cost-construction model to assess the total cost of an anesthesiology residency program

Background: Although the total costs of graduate medical education are diff icult to quantify, this information may be of great importance for health p olicy and planning over the next decade. This study describes the total cos ts associated with the residency program at the University of Texas-Houston Department of Anesthesiology during the 1996-1997 academic year. Methods; The authors used cost-construction methodology, which computes the cost of teaching from information on program description, resident enrollm ent, faculty and resident salaries and benefits, and overhead Surveys of fa culty and residents were conducted to determine the time spent in teaching activities; access to institutional and departmental financial records was obtained to quantify associated costs. The model was then developed and exa mined for a range of assumptions concerning resident productivity, replacem ent costs, and the cost allocation of activities jointly producing clinical care and education. Results: The cost of resident training (cost of didactic teaching, direct c linical supervision, teaching-related preparation and administration, plus the support of the teaching program) was estimated at $75,070 per resident per year. This cost was less than the estimated replacement value of the te aching and clinical services provided by residents, $103,436 per resident p er year. Sensitivity analysis, with different assumptions regarding residen t replacement cost and reimbursement rates, varied the cost estimates but g enerally identified the anethesiology residency program as a financial asse t. Conclusions: In most scenarios, the value of the teaching and clinical serv ices provided by residents exceeded the cost of the resources used in the e ducational program.