To the Editor: In their analysis of hospital
quality ratings for acute myocardial infarction (AMI) by HealthGrades.com,
Dr Krumholz and colleagues1 noted wide variation
in performance among hospitals with the same ratings. Because the ratings
had limited ability to discriminate performance between individual hospitals,
the authors concluded that the rating system is not helpful for consumers
to make informed choices about where to receive care. We disagree with this
conclusion. Although such ratings are not a perfect proxy for hospital performance,
patients at 5-star hospitals will experience, on average, better care and lower mortality. As the authors note, patients choosing
a 5-star hospital over a 1-star hospital will sometimes select the hospital
with worse performance. More often than not, however, patients choosing 5-star
hospitals will select a hospital with better performance.
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