Hospital standardized mortality ratio: consequences of adjusting hospital mortality with indirect standardization.

ABSTRACT:

Background

The hospital standardized mortality ratio (HSMR) is developed to evaluate and improve hospital quality. Different methods can be used to standardize the hospital mortality ratio. Our aim was to assess the validity and applicability of directly and indirectly standardized hospital mortality ratios.

Methods

Retrospective scenario analysis using routinely collected hospital data to compare deaths predicted by the indirectly standardized case-mix adjustment method with observed deaths. Discharges from Dutch hospitals in the period 2003-2009 were used to estimate the underlying prediction models. We analysed variation in indirectly standardized hospital mortality ratios (HSMRs) when changing the case-mix distributions using different scenarios. Sixty-one Dutch hospital

SUBMITTER: Pouw ME 

PROVIDER: S-EPMC3621877 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature