Monitoring changes in hospital standardised mortality ratios

Including post-discharge mortality in calculation of hospital standardised mortality ratios: retrospective analysis of hospital episode statistics

OBJECTIVES To assess the consequences of applying different mortality timeframes on standardised mortality ratios of individual hospitals and, secondarily, to evaluate the association between in-hospital standardised mortality ratios and early post-discharge mortality rate, length of hospital stay, and transfer rate. DESIGN Retrospective analysis of routinely collected hospital data to compar...

Evidence of methodological bias in hospital standardised mortality ratios: retrospective database study of English hospitals

OBJECTIVE To assess the validity of case mix adjustment methods used to derive standardised mortality ratios for hospitals, by examining the consistency of relations between risk factors and mortality across hospitals. DESIGN Retrospective analysis of routinely collected hospital data comparing observed deaths with deaths predicted by the Dr Foster Unit case mix method. SETTING Four acute N...

Variations in hospital standardised mortality ratios (HSMR) as a result of frequent readmissions

BACKGROUND We investigated the impact that variations in the frequency of readmissions had upon a hospital's standardised mortality ratio (HSMR). An adapted HSMR model was used in the study. Our calculations were based on the admissions of 70 hospitals in The Netherlands during the years 2005 to 2009. METHODS Through a retrospective analysis of routinely collected hospital data, we calculated...

Hospital standardized mortality ratios.

Quantifying the Potential Bias when Directly Comparing Standardised Mortality Ratios for In-Unit Neonatal Mortality

INTRODUCTION The Standardised Mortality Ratio (SMR) is increasingly used to compare the performance of different healthcare providers. However, it has long been known that differences in the populations of the providers can cause biased results when directly comparing two SMRs. This is potentially a particular problem in neonatal medicine where units provide different levels of care. METHODS ...