Wednesday, August 10, 2011

Do Bee a Do Bee,

Lauren Do has a post up this morning about hospital quality.  It would be worth fisking if I had the time.  On the other hand, Lauren has admitted she doesn't have a dog in the fight so she might actually be trying to engage in an honest debate.  (Hard to tell because although I think she is intellectually curious enough to want answers, she is politically engaged enough to want those answers to come out a certain way; that is, in favor of the political clique she belongs to.)  I don't comment at Lauren's site, but feel free to engage in the comments here if you wish me to respond.  A couple points to hopefully start off the discussion:

1.  I read each of the studies through, but many are copyrighted  and require paid access so I only posted the abstracts which give full bibliographic information and contain the information that the researchers thought was most important for those with limited time.    If Lauren wants copies, she can pay for them or contact someone with access to paid subscriptions.

2.  I'm not sure what Lauren's point was in pulling quotes from the NEJM, March 25, 2010 article, "Hospital Volume and 30-Day Mortality for Three Common Medical Conditions" since they hardly contradict anything I have said.

3.  I urge you to read the full report that she posted where she excerpted the quote regarding caution in using hospital volume as a proxy for quality. 
       -It is an admirable piece of consumer information, but hardly a peer reviewed article.
       -Overall, it has more information that supports my thesis than contradicts it.
       -It's main purpose, if you read to the conclusion, is to tell Pennsylvanians what a wonderful job the state agency who wrote the report is doing in collecting real hospital quality information so they don't have to worry about proxies.

See you in the comments and I am still open to face to face meetings with people.

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