To the Editor: The article by Shortell and Hughes (April 28 issue)* concluded that highly regulated hospital environments are associated with higher mortality rates. As defined in this study, “mortality rate” actually signified the ratio of hospital deaths to hospital admissions. It should have been stated that a high ratio can be due to either an increase in the number of deaths or a decrease in the number of admissions. Although Shortell and Hughes focused only on the possibility that a high rate is a reflection of increased deaths, it seems equally, if not more, plausible that their results may.
ASJC Scopus subject areas