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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 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.

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