Science / Medicine : U.S. Defends Mortality Statistics

In a study that the U.S. Health Care Financing Administration (HCFA) called “off-base” and “unfortunate,” researchers at the New York University Medical Center and UCLA Medical Center charged last week that the annual Medicare mortality information made public by the federal government paints a misleading picture of the quality of care in the nation’s hospitals.

The new study, published in the Journal of the American Medical Assn., said that the federal death rate statistics fail to adequately account for differences in the sickness of elderly and disabled patients insured by Medicare when they enter the hospital. The government’s listing of mortality rates is “a disservice (and) unnecessarily provokes fear in the minds of consumers of health care, particularly the elderly,” said Jesse Green, director for health policy research at New York University Medical Center and the principal author of the study. But Louis B. Hays, the HCFA acting administrator, said the results “are not only contrary to our own study,” which shows the federal statistics are “increasingly reliable,” but “of little value since they didn’t test the methods we actually used.”

The 1988 federal statistics, released in December, included marked improvements in the statistical techniques previously used to prepare the study. The medical journal article was based on an inexact replication of the methods HCFA used in preparing its 1986 report, Green said.