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Comment & Response
November 2018

Ensuring Optimal Adjustment for Determinations of Institutional Quality

Author Affiliations
  • 1Rocky Mountain Regional Veterans Affairs Medical Center, Denver, Colorado
  • 2Veterans Affairs Clinical Assessment, Reporting and Tracking (CART) Program, Denver, Colorado
  • 3North Florida/South Georgia Veterans Health System, Gainesville
  • 4VA Office of Subspecialty Care, National Cardiology Program, Washington, DC
JAMA Cardiol. 2018;3(11):1129-1130. doi:10.1001/jamacardio.2018.3256

To the Editor Groeneveld et al1 explored variation in risk-standardized mortality for congestive heart failure and ischemic heart disease using administrative data across Veterans Affairs (VA) hospitals. The authors found significant variation in mortality across facilities, with nearly 2-fold differences in both disease states. These findings raise concerns given the VA’s goal to ensure high-quality care throughout the largest integrated health care system in the United States.

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