1. Section Editor(s): Pfeifer, Gail M. MA, RN

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The cost-to-quality relationship is inconsistent, depending on the condition. A report in the February 22 issue of Archives of Internal Medicine analyzed Medicare records from a sampling of 3,146 U.S. hospitals to see whether there was a correlation between the cost of care and care quality as they pertain to specific conditions. The records of approximately 400,000 patients treated for heart failure and almost 400,000 with pneumonia were studied. Findings showed that patients in hospitals spending less had shorter stays by approximately one day for both conditions; the six-month cost for patients with heart failure ranged from $12,715 to $18,411. When it came to treating heart failure, more expensive hospitals had higher quality-of-care scores and better mortality and 30-dayreadmission rates. On the other hand, hospitals spending less to treat pneumonia had higher care-quality scores, better mortality rates, and similar readmission rates. The authors concluded that their results do not "support the penny-wise and pound-foolish hypothesis that low-cost hospitals discharge patients earlier, only to increase readmission rates and incur greater inpatient cost of care over time."