To the Editor.—
Ray and colleagues1 recently reported that mortality following hip fracture was not affected by the implementation of the prospective payment system (PPS). In a 20% sample of Medicare enrollees residing in Michigan, the mortality rate in the year following hospital admission for hip fracture did not differ between the 2130 patients in the 2 years before and the 2238 patients in the 2 years after PPS (23.2% vs 23.7%).Our prospective cohort study2 of a southern California retirement community provides additional data on the subject. The residents of Leisure World Laguna Hills are almost entirely white, moderately affluent, and about two thirds are female. A complete roster of community residents, including address, date of birth, and date of move-in is kept by the community business office and was made available to us for this survey. The residents as of June 1, 1981, with newcomers as of June 1,
Hill AP, Hsu G, Ducey B, Hawk M. Hip Fracture Mortality and Prospective Payment System. Arch Intern Med. 1992;152(3):639. doi:10.1001/archinte.1992.00400150143026
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