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ARTICLES:
Julie A. Choudhuri, Lorraine G. Ogden, A. James Ruttenber, Deborah S.K. Thomas, James K. Todd, and Eric A.F. Simoes
Effect of Altitude on Hospitalizations for Respiratory Syncytial Virus Infection
Pediatrics 2006; 117: 349-356 [Abstract] [Full text] [PDF]
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[Read eLetters] Incomplete Hypothesis
John Grima   (1 February 2006)

Incomplete Hypothesis 1 February 2006
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John Grima,
Hospital Manager
McKay-Dee Hospital, Ogden, UT

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Re: Incomplete Hypothesis

j.grima{at}comcast.net John Grima

The authors write as if the most likely influences governing variation in admission patterns from one locale to another are clinical variables or components of the physical environment. Not so. Per the Dartmouth Atlas studies of Medicare patients, as likely are physician demographics and the availability of hospital beds. Confounding is a real possibility, as the distribution of physicians and beds is very likely correlated with altitude in Colorado, with Denver, Boulder, Colorado Springs and other Front Range communities having the bulk of these resources. It may also be that communities above 2500 meters (resort areas?) tend to have more doctors and more beds per capita. At any rate, without having explored these possible influences on hospitalization rates, this study is certainly not definitive, and it is as likely to be misleading as it is to be suggestive.

John Grima Ogden, Utah

Conflict of Interest:

None declared