Abstract
The introduction of the Medicare Prospective Payment System (PPS) is markedly influencing the environment in which hospitals care for patients, teach medical students and residents, and perform clinical research. Hospitals, particularly teaching institutions, are responding to this challenge by developing new management reports, by analyzing physicians' practice patterns, and by estimating more precisely the fixed and variable costs of various ancillary services. The common objective of these activities is to improve our knowledge of clinical practices, and thereby improve decisions relating to the cost-effectiveness and quality of care delivered to patients in the hospital.

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