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Medical centers in the United States are conglomerations of health-care facilities including hospitals and research facilities that also either include or are closely affiliated with a medical school. Although the term medical center is sometimes used to refer to any concentration of health-care providers including local clinics and individual hospital buildings the term is more properly used to refer to larger facilities or groupings of facilities that include a full spectrum of health services, medical education and medical research.
The major medical centers represent the crown jewels of health care in the United States. They vary greatly in their organization, the services they provide, and their ownership and operation.
In the United States, ownership of the health care system is mainly in private hands, though federal, state, county, and city governments also own certain facilities. Many major hospitals, generally the backbone of any medical center, are non-profit and many of these have their origins in religious organizations. Despite their non-profit status, affiliation with private ventures and major medical schools often allows them to maintain state-of-the-art facilities and services. The non-profit hospital's share of total hospital capacity has remained relatively stable (about 70%) for decades.[1] There are also privately owned for-profit hospitals as well as government hospitals in some locations, mainly owned by county and city governments.
Major medical centers provide many specialized services, some even containing multiple specialized hospitals and clinics each dedicated to specific types of patients and/or services. Additionally they are centers of medical education, centers of medical research, and incubators for medical innovation and technology. A given medical center may include a medical school in the same complex as the rest of the facilities or may be closely affiliated with a medical school on a nearby campus. Similarly a given medical school may be closely associated with multiple tightly linked hospital campuses which function to some degree as a unit though the group may not be referred to as a single medical center (e.g. the Harvard Medical School network of teaching hospitals).
There are about 1,100 teaching hospitals in the United States. Approximately 375 of the larger institutions belong to the Association of American Medical Colleges’ Council of Teaching Hospitals and Health Systems (COTH). COTH teaching hospitals train about 75 percent of residents yearly and provide more than 40 percent of all hospital charity care in the nation.
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