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Previous Volume 331:336 August 4, 1994 Number 5 Next

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To the Editor: We wish to inform you of an error in our paper "the Deteriorating Administrative Efficiency of the U.S. Health Care System" (May 2, 1991, issue).¹ The error was brought to our attention by Mr. Gilles Fortin of the Health Information Division of Health and Welfare Canada in a letter dated May 30, 1994. Mr. Fortin and his former supervisor (Mr. L.W. Rehmer, director of the Health Information Division) supplied us with data on hospital administrative costs in Canada that we cited in our paper. In preparing an updated report on trends in these costs, Mr. Fortin discovered that the tabulations that he and Mr. Rehmer had sent us on April 23, 1990, included an inadvertent error in transcription; they listed costs in the category "nursing administration" as $21.1 million, rather than the correct figure of $242.0 million (Canadian dollars).

As a result of this error in raw data, our calculations understated hospital administrative costs in Canada. They accounted for 10.4 percent of spending by Canadian hospitals, not 9.0 percent as we originally reported. Per capita costs for hospital administration in Canada amounted to $58 (U.S. dollars), not $50 as we reported. Total costs per capita for health administration in Canada ranged from $125 to $164, rather than from $117 to $156 as we reported.

We do not believe that these corrections materially change the interpretation of the data presented in the paper, that costs for health care administration are increasing in the United States and are much higher than those in Canada.

Steffie Woolhandler, M.D., M.P.H.
David U. Himmelstein, M.D.
Cambridge Hospital
Cambridge, MA 02139

References

1. Woolhandler S, Himmelstein DU. The deteriorating administrative efficiency of the U.S. health care system. N Engl J Med 1991;324:1253-1258. [Abstract]

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