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Letters |

Should Consumers Trust Hospital Quality Report Cards?

Emily V. A. Finlayson, MD; John D. Birkmeyer, MD
JAMA. 2002;287(24):3206-3208. doi:10.1001/jama.287.24.3206.
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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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