Edited by Drummond Rennie, MD, Deputy Editor (West), and Margaret A. Winker, MD, Senior Editor.
To the Editor. —The conclusions about rural hospitals reached by Keeler et al1 were disconcerting and somewhat misleading. In particular, I question the authors' conclusion that rural hospitals provide care that was "below average" compared with urban hospitals. First, the study is based on data from 1985 and 1986. Much has changed in the realm of rural hospitals during the intervening period. The data used in the study are 6 years old, and substantial changes in Medicare policies have occurred since then. The Prospective Payment Assessment Commission submitted a report to Congress in 1991, Rural Hospitals Under Medicare's PPS (prospective payment system), which found that congressional mandates had their intended effect of improving rural hospital performance. Many rural hospitals have closed, many have restructured services to better treat their patients, and legislation has been enacted that has allowed rural hospitals to upgrade services and redirect funding to projects to
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
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