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August 16, 2000

Managed Care Insurance and Use of Higher-Mortality Hospitals

Author Affiliations

Stephen J.LurieMD, PhD, Contributing EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor

JAMA. 2000;284(7):829-831. doi:10.1001/jama.284.7.827

To the Editor: Dr Erickson and colleagues1 reported that New York State patients with private managed care insurance were less likely to undergo CABG surgery in hospitals with below average risk-adjusted mortality rates than patients with FFS insurance. Our analysis,2 also based on data from the New York State hospital discharge database for 1996 but using somewhat different methods, suggests that the results of Erickson et al mask important regional differences. We believe that these differences are worth noting, not only with respect to specific conclusions, but also as a methodological caution about making inferences from models that pool together data from different regional markets.

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