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May 28, 2003

Measuring Improvement in Quality of Care—Reply

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289(20):2647. doi:10.1001/jama.289.20.2647-a

To the Editor: Dr Jencks and colleagues1 reported that states' performance on 22 indicators of medical quality improved by an overall 3% between 1998-1999 and 2000-2001 although there was significant variation between states. The data were quite complex; with 52 state rates for 22 quality indicators, there was a total of 1144 individual outcomes. The authors assisted interpretation of this large data set by providing a state ranking for each indicator and calculating an overall state ranking using the average of individual indicators' relative rankings. Studies have found, however, that most people can generally assimilate only 5 to 7 variables in such a quality assessment.2

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