Measuring Hospital-wide Mortality: Pitfalls and Potential

Mackenzie SJ, Goldmann DA, Perla RJ, Parry GJ. Measuring hospital-wide mortality—pitfalls and potential. Journal for Healthcare Quality. 2014 Aug 7. Epub ahead of print.

This article explores potential uses for measures of risk-adjusted hospital-wide mortality, a proposed key indicator of health care quality at the system level. Several risk-adjusted measures are available and the hospital standardized mortality ratio (HSMR) is publicly reported in several countries, but not in the US. The authors describe pitfalls of using these measures, concluding that available methods aren’t appropriate for inter-hospital comparisons or rankings. They also note that disaggregated condition- and service-line-specific mortality measures can be used to facilitate targeted improvement efforts.

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