{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T20:53:31Z","timestamp":1792011211759,"version":"4.4.0"},"reference-count":19,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32GM144274"],"award-info":[{"award-number":["T32GM144274"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","surgjournal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Surgery"],"published-print":{"date-parts":[[2026,9]]},"DOI":"10.1016\/j.surg.2026.110677","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T23:16:02Z","timestamp":1790205362000},"page":"110677","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Graduate medical education funding and hospital quality: A longitudinal analysis of 881 teaching hospitals"],"prefix":"10.1016","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1721-9124","authenticated-orcid":false,"given":"Lorenzo","family":"Hiraldo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler","family":"Zander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel L.","family":"Wolansky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Sujka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Hall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marshall S.","family":"Baker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul C.","family":"Kuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.surg.2026.110677_bib1","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.amjsurg.2020.06.007","article-title":"Graduate medical education funding mechanisms, challenges, and solutions: a narrative review","volume":"221","author":"He","year":"2021","journal-title":"Am J Surg"},{"key":"10.1016\/j.surg.2026.110677_bib3","series-title":"Graduate Medical Education That Meets the Nation's Health Needs","year":"2014"},{"key":"10.1016\/j.surg.2026.110677_bib4","series-title":"Medicare Graduate Medical Education, 2025","year":"2025"},{"key":"10.1016\/j.surg.2026.110677_bib5","series-title":"Social Security Amendments of 1965. Pub L No. 89-97, 79 Stat 286","year":"1965"},{"key":"10.1016\/j.surg.2026.110677_bib6","series-title":"On Implementing a National Graduate Medical Education Trust Fund","year":"1997"},{"key":"10.1016\/j.surg.2026.110677_bib7","series-title":"Balanced Budget Act of 1997: Implications for Graduate Medical Education","author":"Reuter","year":"1997"},{"key":"10.1016\/j.surg.2026.110677_bib8","series-title":"Does It Cost More to Train Residents or to Replace Them?","author":"Wynn","year":"2013"},{"key":"10.1016\/j.surg.2026.110677_bib9","series-title":"Medicare: Caps on Teaching Hospital Payments Have Resulted in Billions in Lost Revenue","year":"2021"},{"key":"10.1016\/j.surg.2026.110677_bib10","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1370\/afm.17","article-title":"The Balanced Budget Act of 1997 and the financial health of teaching hospitals","volume":"2","author":"Phillips","year":"2004","journal-title":"Ann Fam Med"},{"key":"10.1016\/j.surg.2026.110677_bib11","series-title":"Section 126: Distribution of Additional Residency Positions. Consolidated Appropriations Act, 2021","year":"2021"},{"key":"10.1016\/j.surg.2026.110677_bib12","series-title":"Report to the Congress: Medicare Payment Policy. Chapter 4: Graduate Medical Education Financing","year":"2020"},{"key":"10.1016\/j.surg.2026.110677_bib13","doi-asserted-by":"crossref","DOI":"10.1097\/AS9.0000000000000073","article-title":"Association of teaching status and mortality after cancer surgery","volume":"2","author":"Lam","year":"2021","journal-title":"Ann Surg Open"},{"key":"10.1016\/j.surg.2026.110677_bib14","series-title":"Data Brief: Evaluation of National Distributions of Overall Hospital Quality Star Ratings","year":"2016"},{"key":"10.1016\/j.surg.2026.110677_bib16","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1007\/s11606-018-4442-6","article-title":"Impact of teaching intensity and sociodemographic characteristics on CMS Hospital Compare quality ratings","volume":"33","author":"Wan","year":"2018","journal-title":"J Gen Intern Med"},{"key":"10.1016\/j.surg.2026.110677_bib17","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1046\/j.1525-1497.2002.10804.x","article-title":"Medicare financing of graduate medical education","volume":"17","author":"Rich","year":"2002","journal-title":"J Gen Intern Med"},{"key":"10.1016\/j.surg.2026.110677_bib18","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1001\/jamainternmed.2019.4429","article-title":"Changes and variation in Medicare graduate medical education payments among teaching hospitals","volume":"180","author":"Chen","year":"2020","journal-title":"JAMA Intern Med"},{"key":"10.1016\/j.surg.2026.110677_bib19","doi-asserted-by":"crossref","first-page":"E1","DOI":"10.5600\/mmrr.001.04.a01","article-title":"Indirect medical education and disproportionate share adjustments to Medicare inpatient payment rates","volume":"1","author":"Nguyen","year":"2011","journal-title":"Medicare Medicaid Res Rev"},{"key":"10.1016\/j.surg.2026.110677_bib20","series-title":"Report to the Congress: Medicare and the Health Care Delivery System","article-title":"Revising Medicare's indirect medical education payments to better reflect teaching hospitals' costs","year":"2021"},{"key":"10.1016\/j.surg.2026.110677_bib21","series-title":"Medicaid Graduate Medical Education Payments: Results from the 2022 50-State Survey","author":"Henderson","year":"2023"}],"container-title":["Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0039606026006021?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0039606026006021?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T20:38:55Z","timestamp":1792010335000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0039606026006021"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":19,"alternative-id":["S0039606026006021"],"URL":"https:\/\/doi.org\/10.1016\/j.surg.2026.110677","relation":{},"ISSN":["0039-6060"],"issn-type":[{"value":"0039-6060","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Graduate medical education funding and hospital quality: A longitudinal analysis of 881 teaching hospitals","name":"articletitle","label":"Article Title"},{"value":"Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.surg.2026.110677","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"110677"}}