Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor
To the Editor: Dr Asch and colleagues1 use Medicare claims data to assess whether fee-for-service beneficiaries are provided "necessary care" as defined by adherence to a measure set developed by a RAND expert panel using the Delphi method. Because the authors state that the measure set represents "minimal quality standard(s) for the average patient seeing the average physician," they conclude that their results suggest "that underuse of necessary care is widespread." An alternative explanation is that the observed performance gap can be partly attributed to justifiable differences of opinion between "expert panel physicians" and "average practicing physicians."
Pogach L. Overuse of Administrative Data to Measure Underuse of Care. JAMA. 2001;285(6):735-737. doi:10-1001/pubs.JAMA-ISSN-0098-7484-285-6-jlt0214