The Three-Step Workflow: A Pragmatic Approach to Allocating Academic Hospitals’ Affiliations for Bibliometric Purposes

This paper presents a method for classifying the varying degrees of interdependency between academic hospitals and universities in the context of the Leiden Ranking. A key question for ranking universities is whether or not to allocate the publication output of affiliated hospitals to universities. Hospital nomenclatures vary worldwide to denote some form of collaboration with a university: academic hospitals, teaching hospitals, university hospitals, and academic medical centres do not correspond to universally standard definitions. Thus, rather than seeking a normative definition of academic hospitals, we are proposing a workflow that aligns the university-hospital relationship with one of three general models: full integration of the hospital and the medical faculty into a single organization; health science centres in which hospitals and medical faculty remain separate entities albeit within the same governance structure; and structures in which universities and hospitals are separate entities which collaborate with one another. This classification system provides a standard by which we can allocate publications which note affiliations with academic hospitals. Our three-step workflow effectively translates the three above-mentioned models into two types of instrumental relationships for the assignation of publications:"associate"and"component". When a hospital and a medical faculty are fully integrated or when a hospital is part of a health science centre, the relationship is classified as component. When a hospital follows the model of collaboration and support, the relationship is classified as associate. The compilation of data following these standards allows for a more uniform comparison between worldwide educational and research systems.

[1]  An international association of academic health centres , 2009, The Lancet.

[2]  Academic health sciences networks in England , 2013, The Lancet.

[3]  P. Griner,et al.  Reforming the structure and management of academic medical centers: case studies of ten institutions , 1998, Academic medicine : journal of the Association of American Medical Colleges.

[4]  S. Chimonas,et al.  Academic medical centers' conflict of interest policies. , 2010, JAMA.

[5]  V. Fuchs.  Current challenges to academic health centers. , 2013, JAMA.

[6]  H. Smits,et al.  Managing the interface between medical schools, hospitals, and clinical research. , 1997, JAMA.

[7]  Philip G. Altbach,et al.  Globalisation and the University: Myths and Realities in an Unequal World , 2004 .

[8]  Eric G Campbell,et al.  Life-science research within US academic medical centers. , 2009, JAMA.

[9]  Jordan J. Cohen,et al.  Academic medical centers and medical research: the challenges ahead. , 2005, JAMA.

[10]  I. Jacobs,et al.  Academic health science systems , 2010, The Lancet.

[11]  C. Propper,et al.  Can Governments Do it Better? Merger Mania and Hospital Outcomes in the English NHS , 2011, Journal of health economics.

[12]  David T Feinberg,et al.  Academic health centers and the evolution of the health care system. , 2013, JAMA.

[13]  D. Dill.  Convergence and Diversity: The Role and Influence of University Rankings 1 , 2009 .

[14]  S. Wartman.  Toward a virtuous cycle: the changing face of academic health centers. , 2008, Academic medicine : journal of the Association of American Medical Colleges.

[15]  Ara Darzi,et al.  Improving accountability through alignment: the role of academic health science centres and networks in England , 2014, BMC Health Services Research.

[16]  M. Berg.  The Framework for Qualifications of the European Higher Education Area , 2005 .

[17]  R. Daniels,et al.  Academic medical centers--organizational integration and discipline through contractual and firm models. , 2011, JAMA.

[18]  Establishing the SouthWestern Academic Health Network (SWAHN): A Survey Exploring the Needs of Academic and Community Networks in SouthWestern Ontario , 2015, Journal of Community Health.

[19]  R. Fox,et al.  Academic health sciences centres laid bare. , 2002, HealthcarePapers.

[20]  Wenxin Wang,et al.  Perceived health-care quality in China: a comparison of second- and third-tier hospitals. , 2021, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[21]  Diana Hicks,et al.  Science policy for a highly collaborative science system , 1996 .

[22]  Sjoerd Hardeman.  Organization level research in scientometrics: a plea for an explicit pragmatic approach , 2012, Scientometrics.

[23]  S. Wartman.  The academic health center in a disrupted world. , 2015, The Pharos of Alpha Omega Alpha-Honor Medical Society. Alpha Omega Alpha.

[24]  Kiyohide Fushimi,et al.  Impact of teaching intensity and academic status on medical resource utilization by teaching hospitals in Japan. , 2012, Health policy.

[25]  Jordan J. Cohen,et al.  Health industry practices that create conflicts of interest: a policy proposal for academic medical centers. , 2006, JAMA.

[26]  S. Davies,et al.  Structure, Governance, and Organizational Dynamics of University Medical Centers in the Netherlands , 2010, Academic medicine : journal of the Association of American Medical Colleges.

[27]  D. Barrett.  The evolving organizational structure of academic health centers: the case of the University of Florida. , 2008, Academic medicine : journal of the Association of American Medical Colleges.

[28]  L. Nonnemaker,et al.  The Effects of a Changing Environment on Relationships between Medical Schools and Their Parent Universities , 2001, Academic medicine : journal of the Association of American Medical Colleges.

[29]  Francine Rochford,et al.  Is there any Clear Idea of a University? , 2006 .

[30]  E. Ferlie,et al.  The international spread of Academic Health Science Centres: a scoping review and the case of policy transfer to England. , 2014, Health policy.