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CAT Critical Reasoning Practice question with Solution 99

Several studies have shown that hospitals are not all equally successful: patients are much more likely to die in some of them than in others. Since the hospitals in the studies had approximately equal per-patient funding, differences in the quality of care provided by hospital staff are probably responsible for the differences in mortality rates.

Which one of the following, if true, casts the most doubt on the conclusion drawn above?

[A]. The staff in some of the hospitals studied had earned more advanced degrees, on average, than the staff in the other hospitals.
[B]. Patient populations vary substantially in average severity of illness from hospital to hospital.
[C]. The average number of years that staff members stay on at a given job varies considerably from one hospital to another.
[D]. Approximately the same surgical procedures were performed in each of the hospitals covered in the studies.
[E]. Mortality rates for hospital patients do not vary considerably from one region of the country to another.
Answer: B

The author concludes that the higher patient mortality rates in certain hospitals as opposed to others are probably the result of lower quality care. The evidence for this includes the fact that the hospitals all had roughly the same per-patient funding; in other words, lack of money didn’t account for the poor hospitals’ bad showing. But that eliminates only one other possible explanation for the result. Another, equally plausible explanation why some hospitals are deadlier than others (other than differences in the quality of care provided) would severely weaken the argument. We get this plausible explanation in (B): If some hospitals receive much sicker patients than others, then the difference in mortality rates might reflect the difference in the severity of the patients’ illnesses rather than a difference in the quality of care the hospital provides.

(A) Even if the high death rates in some hospitals are due to the fact that the staff in these hospitals has less training, this would strengthen the argument, by making it plausible that the poorly trained personnel are providing lower quality care.

(C) is irrelevant, as we have no way of knowing from this statement which hospitals have the most experienced staffs. And even if we did know, we still wouldn’t be able to legitimately tie this info in with the quality of care issue. (C) is simply way too vague to damage the argument.

(D) Au-contraire: (D) slightly strengthens the argument by eliminating a possible alternative reason for the difference in death rates—the types of surgery offered

(E) essentially does the same thing as (D), by eliminating another possible explanation (regional differences not related to quality of care) that otherwise could damage the argument. If mortality rates are the same from region to region, then the difference in rates between hospitals can’t be due to what region they’re in.

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