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Alan C. Brewster, MD
Vice Chairman of the Board and Director, Applied Research Division

Diane M. Throop, MS
Chief Statistician MediQual Systems, Inc Westborough, Mass

JAMA. 1991;266(19):2704.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—Dr Blumberg¹ recently described "bias" in the 1987 MedisGroups admission severity score. One conclusion was that severity is not a sufficient adjuster for interhospital comparisons. We studied three factors discussed by Blumberg using the 1991 MedisGroups system. Our study confirms the results of his analysis relative to the presence of bias, but suggests that bias does not have a practical effect on interhospital comparisons for two of the three factors.

We used data from 32 hospitals in the current MedisGroups database with at least 100 acute myocardial infarction (AMI) (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes 410.0 to 410.9) Medicare admissions greater than age 65 years (4653 cases). We studied location of AMI, congestive heart failure (CHF) status, and patient age using the categories in Blumberg's article and calculating X² values.

We then measured the effect of bias on interhospital comparisons by . . . [Full Text PDF of this Article]

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