Reprint requests to Department of Quality-of-Care Measurement, Harvard Community Health Plan, 10 Brookline Pl W, Brookline, MA 02146 (Dr Berwick).
This article was corrected | View correction
The release of hospital-specific mortality data by the Health Care Financing Administration has stirred controversy about the adequacy of current case-mix adjustment models and about the wisdom in general of public release of outcome data. We surveyed a national sample of hospitals, stratified by measured mortality rate, in the 1987 Health Care Financing Administration data release to determine the reactions of hospital leaders to the data and to learn if hospitals with high mortality had different attitudes from those of hospitals with average or low mortality as measured by the Health Care Financing Administration. Seventy-eight percent (N = 195) responded. All hospitals, regardless of mortality rate, shared an extremely negative view of the accuracy, usefulness, and interpretability of the Health Care Financing Administration's mortality data. The lowest possible rating (poor) was given by 70% of the respondents on the question of usefulness of the data to the hospital, by 54% on accuracy of the data, and by 85% on usefulness of the data to consumers. Only 31% of the respondents said that they had used the data at all for internal purposes and 20% reported that the data release had caused problems for the hospital. Hospitals in the high-mortality group were more likely than others to report both use of the data and problems from its release. Publication of outcome data to encourage quality improvement may face severe and pervasive barriers in the attitudes and reactions of hospital leaders who are potential clients for such data.
(JAMA. 1990;263:247-249)
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
Instructions
Comments are moderated and will appear on the site at the discretion of the Journal of American Medical Association editors. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest* Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Customize your page view by dragging & repositioning the boxes below.
and access these and other features:
Register Now
Enter your username and email address. We'll send you a reminder to the email address on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.