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March 25, 1998

Risk Adjustment, Quality Assessment, and Process of Care

JAMA. 1998;279(12):910-911. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-12-jbk0325

To the Editor.—Dr Iezzoni1 compared risk-adjustment methods for use with mortality outcomes and discussed how we cannot live with them or without them. In doing so, the author revealed apparent gaps in experience and understanding of current practices in quality improvement that in fact misrepresent much of it. That work today may or may not use risk-adjusted mortality outcomes, but it surely will include measures of processes of care, which go largely ignored in her article.