Stephen J.LurieMD, PhD, Contributing EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor
To the Editor: Dr Erickson and colleagues1 concluded that patients with managed care insurance
were less likely than those with fee-for-service (FFS) insurance to undergo
coronary artery bypass grafting (CABG) at hospitals with lower mortality rates.
However, the data in Table 1 of their article provide evidence that CABG inpatient
mortality rates among patients enrolled in managed care plans are equal to
or better than mortality rates among those in non–managed care plans.
The authors minimize this central finding because they focus on the likelihood
of using "lower-mortality hospitals," a very difficult metric to interpret.
Ensor JE, Grana JR, Diamond CC. Managed Care Insurance and Use of Higher-Mortality Hospitals. JAMA. 2000;284(7):829-831. doi:10.1001/jama.284.7.827