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The Measure and Mismeasure of Hospital Quality: Appropriate Risk-Adjustment Methods in Comparing Hospitals

Albert W. Wu, MD, MPH
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The Johns Hopkins University; Baltimore, MD 21205-1901 Requests for Reprints: Albert W. Wu, MD, MPH, Health Services Research and Development Center, Department of Health Policy and Management, The Johns Hopkins University, School of Hygiene and Public Health, 624 North Broadway, Baltimore, MD 21205-1901.


Copyright ©2004 by the American College of Physicians


Ann Intern Med. 1995;122(2):149-150. doi:10.7326/0003-4819-122-2-199501150-00013
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Hospital quality assessment is a growth industry. Initial attention has focused on mortality rates as a measure of quality. Since the Medicare mortality rates were first released in 1986 [1], increasingly numerous and various parties have compiled actual and expected hospital mortality rates to motivate improvements in quality and to compare hospitals. The federal government, state governments, peer review organizations, private insurers, and hospital associations have been among those producing such assessments. Lately, large employers have also become interested in assessing hospital quality [2]. Concerned about the value they receive for dollars invested in employee health benefit packages, companies are taking decisions about the buying of health care into their own hands, as Localio and colleagues describe in this issue [3].

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