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To the Editor: In reviewing the study by Dr Jencks and colleagues¹ on state-level variations in quality of care for Medicare beneficiaries, we were struck initially by the low relative rankings of states in the Southeast. Further review revealed that many non-southern states with significant minority populations also performed relatively poorly. We are concerned that Jencks et al did not specifically address this issue. This is especially troubling given that an extensive research literature documents pervasive and persistent disparities in the care delivered to racial and ethnic minorities,² including Medicare recipients.³

We endorse the efforts of Jencks et al to improve the quality of care for Medicare beneficiaries by holding the US Health Care Financing Administration and its peer review organizations publicly accountable for their performance. However, we believe that a continued focus on traditional quality improvement efforts through the peer review organizations, without explicitly incorporating strategies to eliminate racial . . . [Full Text of this Article]

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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Physicians' Perceptions of Patients' Social and Behavioral Characteristics and Race Disparities in Treatment Recommendations for Men With Coronary Artery Disease
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