REPLY
A Return to Farr and Nightingale
Lisa I. Iezzoni, MD, MSc
15 July 1997 | Volume 127 Issue 2 | Page 171
IN RESPONSE:
As I said in response to the first letter of Drs. Vandenbroucke and Vandenbroucke-Grauls, their assertions are reasonable. It all boils down to context: My comments were framed by current state and regional initiatives to publish "report cards" on hospitals. I cannot imagine the Pennsylvania Health Care Cost Containment Council [1], New York's Cardiac Surgery Reporting System [2], or Cleveland Health Quality Choice [3] using the number of deaths per 100 days in-hospital in their report cards on hospital mortality rates. Given the common English meaning of the words "death rate," such figures would not make intuitive sense to the average reader.
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Author and Article Information
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Beth Israel Deaconess Medical Center; Boston, MA 02215
1. Pennsylvania Health Care Cost Containment Council. Focus on Heart Attack in Western Pennsylvania. A 1993 Summary Report for Health Benefits Purchasers, Health Care Providers, Policy-makers, and Consumers. Harrisburg, PA: Pennsylvania Health Care Cost Containment Council; 1996.
2. Chassin MR, Hannan EL, DeBuono BA. Benefits and hazards of reporting medical outcomes publicly. N Engl J Med. 1996; 334:394-8.
3. Rosenthal GE, Harper DL. Cleveland Health Quality Choice: a model for collaborative community-based outcomes assessment. Jt Comm J Qual Improv. 1994; 20:425-42.
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