Use of Hospital Mortality Rates to Measure Quality of Care

1988 ◽  
Vol 36 (9) ◽  
pp. 860-861 ◽  
Author(s):  
Mark A. Moskowitz
Keyword(s):  
Quality Of Care ◽  
Hospital Mortality ◽  
Mortality Rates

What do hospital mortality rates tell us about quality of care?: Table 1

2013 ◽  
Vol 32 (3) ◽  
pp. 244-247 ◽  
Author(s):  
Steve Goodacre ◽  
Mike Campbell ◽  
Angela Carter
Keyword(s):  
Quality Of Care ◽  
Hospital Mortality ◽  
Mortality Rates

Total patient load, regional disparities and in-hospital mortality of intubated COVID-19 patients in Greece, from September 2020 to May 2021

2021 ◽  
pp. 140349482110599
Author(s):  
Theodore Lytras ◽  
Sotirios Tsiodras
Keyword(s):  
Quality Of Care ◽  
Hospital Mortality ◽  
Poisson Regression ◽  
Healthcare Services ◽  
Regional Disparities ◽  
Time Varying ◽  
Total Patient ◽  
Patient Load ◽  
Time Varying Covariates

Aims: While healthcare services have been expanding capacity during the COVID-19 pandemic, quality of care under increasing patient loads has received less attention. We examined in-hospital mortality of intubated COVID-19 patients in Greece, in relation to total intubated patient load, intensive care unit (ICU) availability and hospital region. Methods: Anonymized surveillance data were analyzed from all intubated COVID-19 patients in Greece between 1 September 2020 and 6 May 2021. Poisson regression was used to estimate the hazard of dying as a function of fixed and time-varying covariates. Results: Mortality was significantly increased above 400 patients, with an adjusted hazard ratio of 1.25 (95% confidence interval (CI): 1.03–1.51), rising progressively up to 1.57 (95% CI: 1.22–2.02) for 800+ patients. Hospitalization outside an ICU or away from the capital region of Attica were also independently associated with significantly increased mortality. Conclusions: Our results indicate that in-hospital mortality of severely ill COVID-19 patients is adversely affected by high patient load even without exceeding capacity, as well as by regional disparities. This highlights the need for more substantial strengthening of healthcare services, focusing on equity and quality of care besides just expanding capacity.

Performance and Quality Indicators: The Importance of Accurate Coding

2012 ◽  
Vol 94 (2) ◽  
pp. 46-50 ◽  
Author(s):  
AJ Cockbain ◽  
M Carolan ◽  
D Berridge ◽  
GJ Toogood
Keyword(s):  
Quality Of Care ◽  
Mortality Rates ◽  
Care Quality ◽  
Third Party ◽  
The Public ◽  
Department Of Health ◽  
Care Quality Commission ◽  
The Media ◽  
Standardised Mortality Ratios

Since the seminal work of Jarman et al in 1999, standardised mortality ratios have been published for all English hospitals in the NHS. These have been widely digested by the media, clinicians, managers and the public alike, with differences in mortality rates taken to represent variation in the overall quality of care provided by institutions. The appetite for comparative data has continued and a wealth of performance data is now made publicly available, be it from the department of Health, the Care Quality Commission, professional bodies maintaining their own specialty registries or from third-party agencies such as dr Foster.

scholarly journals Quality of Care for Patients with Acute Myocardial Infarction (AMI) in Pakistan: A Retrospective Study

2019 ◽  
Vol 16 (20) ◽  
pp. 3890
Author(s):  
Shazia Rehman ◽  
Xi Li ◽  
Chao Wang ◽  
Muhammad Ikram ◽  
Erum Rehman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Quality Of Care ◽  
Hospital Mortality ◽  
Clinical Outcomes ◽  
Care Delivery ◽  
Clinical Care ◽  
Hospital Length Of Stay ◽  
Hospital Outcomes

A wide variation exists in the practice patterns of acute myocardial infarction (AMI) care worldwide, leading to differences in clinical outcomes. This study aims to evaluate the quality of process care and its impact on in-hospital outcomes among AMI patients in Pakistan, as no such study has been conducted in Pakistan thus far based upon recommended guidelines. We investigated a sample of 2663 AMI patients across 11 territory hospitals in Punjab province of Lahore, Faisalabad, Multan, Rawalpindi, and Islamabad from January 1, 2016 to December 31, 2017, with an in-hospital mortality rate of 8.6%. We calculated compliance rates of quality indicators (QIs) for all eligible patients. The association between process care and in-hospital outcome was assessed using hierarchical generalized linear model that adjusted for patient and hospital characteristics. In addition, we examined the effect of patient composite scores on clinical outcomes. Aspirin (73.08%) and clopidogrel (67.86%) indicated relatively better conformance than other QIs. The percutaneous coronary intervention also showed significantly low adherence. All QIs showed no significant association with in-hospital mortality. In contrast, 4 out of 8 QIs were observed positively correlated with in-hospital length of stay (LOS). The overall patient composite score was found to be statistically significant with in-hospital LOS. The assessment of quality of care showed low adherence to clinical care recommendations, and increased adherence was associated with longer in-hospital LOS among AMI patients. Evaluation of valid QIs for AMI treatment and their impact on in-hospital outcomes is an important tool for improving health care delivery in the overall AMI population in Pakistan. Low adherence to performance measures strongly compel to focus on guideline-based tools for AMI in Pakistan.

scholarly journals Weekend Hospital Admission for Heart Failure: Influence on Quality of Care, Length of Stay, and In-Hospital Mortality

2008 ◽  
Vol 14 (6) ◽  
pp. S7-S8
Author(s):  
Tamara B. Horwich Gregg C. Fonarow ◽  
Kenneth A. LaBresh ◽  
Clyde Yancy ◽  
Nancy M. Albert ◽  
Adrian F. Hernandez ◽  
...  
Keyword(s):  
Heart Failure ◽  
Quality Of Care ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Hospital Admission

Reliability of In-hospital Mortality as a Quality Indicator in Clinical Quality Registries

2013 ◽  
Vol 52 (05) ◽  
pp. 432-440 ◽  
Author(s):  
N. Peek ◽  
E. de Jonge ◽  
D. Dongelmans ◽  
G. van Berkel ◽  
N. de Keizer ◽  
...  
Keyword(s):  
Intensive Care ◽  
Quality Of Care ◽  
Hospital Mortality ◽  
Quality Indicator ◽  
Outcome Data ◽  
Mortality Data ◽  
Quality Of Data ◽  
Local Data ◽  
Data Errors

SummaryObjectives: Errors in the registration or extraction of patient outcome data, such as in-hospital mortality, may lower the reliability of the quality indicator that uses this (partly) incorrect data. Our aim was to measure the reliability of in-hospital mortality registration in the Dutch National Intensive Care Evaluation (NICE) registry.Methods: We linked data of the NICE registry with an insurance claims database, resulting in a list of discrepancies in in-hospital mortality. Eleven Intensive Care Units (ICUs) were visited where local data sources were investigated to find the true in-hospital mortality status of the discrepancies and to identify the causes of the data errors in the NICE registry. Original and corrected Stand -ardized Mortality Ratios (SMRs) were calculated to determine if conclusions about quality of care changed compared to the national benchmark.Results: In eleven ICUs, 23,855 records with 460 discrepancies were identified of which 255 discrepancies (1.1% of all linked records) were due to incorrect in-hospital mortality registration in the NICE registry. Two programming errors in computer software of six ICUs caused 78% of errors, the remainder was caused by manual transcription errors and failure to record patient outcomes. For one ICU the performance became concordant with the national benchmark after correction, instead of being better.Conclusions: The reliability of in-hospital mortality registration in the NICE registry was good. This was reflected by the low number of data errors and by the fact that conclusions about the quality of care were only affected for one ICU due to systematic data errors. We recommend that registries frequently verify the software used in the registration process, and compare mortality data with an external source to assure consistent quality of data.

scholarly journals Quality of care for patients with myocardial infarction with ST segment elevation. real clinical practice of the invasive center.

2018 ◽  
Vol 96 (6) ◽  
pp. 506-511
Author(s):  
V. V. Ryabov ◽  
S. K. Demianov ◽  
A. G. Syrkina ◽  
N. V. Belokopitova ◽  
E. V. Vyshlov ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Hospital Mortality ◽  
Medical Care ◽  
Coronary Arteries ◽  
Psychotic Disorders ◽  
Small Diameter ◽  
Left Ventricular ◽  
High Tech ◽  
Coronary Syndrome

According to the Russian registry RECORD, the hospital mortality at STEMI in domestic hospitals remains high, which is due to the low frequency of reperfusion measures. There are problems in treatment patients of senile age. Comparative studies of the quality of care for patients with acute coronary syndrome were not conducted in Russia. 489 patients with STEMI, arrived in the first 24 hours from the onset of MI were analyzed. Quality of care for patients with STEMI was evaluated according to the quality criteria of the Association of Emergency Cardiovascular Care of the European Society of Cardiology. To compare the quality of care for patients of different age groups, the endpoints were the frequency of use of TLT and primary PCI, the incidence of cardiogenic shock, pulmonary edema, acute left ventricular aneurysm, and acute psychotic disorders. It is shown that patients with STEMI receive emergency medical care of high quality in adequate time. Elderly STEMI patients are less likely to undergo percutaneous coronary intervention, have more extensive myocardial damage with severe left ventricular failure and acute psychotic disorders, which is associated with a multiple increase in hospital mortality. The most frequent reasons for rejecting PCI were acute mental disorders, multivessel diffuse lesions of the coronary arteries with pronounced calcinosis, small diameter of the artery. It is necessary to develop new devices or techniques for PCI in conditions of severe multivessel lesions of coronary arteries with pronounced calcification, and also develop methods of neuroprotection in order to overcome existing barriers in providing emergency high-tech medical care to elderly STEMI patients.

Improve Healthcare Quality Through Mortality Committee: Retrospective Analysis of Bambino Gesù Children Hospital’s Ten Years’ Experience 2008-2017

2019 ◽  
Vol 20 (8) ◽  
pp. 635-642 ◽  
Author(s):  
Caterina Offidani ◽  
Maria Lodise ◽  
Vittorio Gatto ◽  
Paola Frati ◽  
Stefano D'Errico ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Hospital Mortality ◽  
Healthcare Quality ◽  
Mortality Rates ◽  
Mortality Data ◽  
Systematic Analysis ◽  
Mortality Review ◽  
Hospital Deaths ◽  
The Impact

Background: Healthcare quality improvements are one of the most important goals to reach a better and safer healthcare system. Reviewing in-hospital mortality data is useful to identify areas for improvement, and to monitor the impact of actions taken to avoid preventable cases, such as those related to healthcare associated infections (HAI). Methods: In this paper, we present the experience of the Mortality Committee of Bambino Gesù Children Hospital (OPBG). OPBG has instituted a process of systematic revision of all in-hospital deaths conducted by a multidisciplinary team. The goal is to identify system-wide issues that could be improved to reduce in-hospital preventable deaths. In this way, the mortality review goes alongside all the other risk management activities for the continuous quality improvement and patient safety. Results: In years 2008-2017, we performed a systematic analysis of 1148 inpatient deaths. In this time period, the overall mortality rate was 0.4%. Forty-seven deaths were caused due to infections, 10 of which involved patients with HAI transferred to OPBG from other facilities or patients with community- acquired infections. Six deaths related to HAI were followed by claims compensations. All these cases were not followed by compensation because the onset of HAI was considered an inevitable consequence of the underlying disease. Conclusion: Introduction of the mortality review committee has proved to be a valid instrument to improve the quality of the care provided in a hospital, allowing early identification of care gaps that could lead to an increase in mortality rates. Article Highlights Box: Reduction of preventable deaths is one of the most important goals to be achieved for any health-care system and to improve the quality of care. • Several studies have shown that analysis of morbidity and mortality rate helps to detect any factors that can lead to an increase in in-hospital mortality rates. • The review of in-hospital deaths allows to learn how to improve the quality and safety of care through identification of critical issues that lead to an increase in mortality ratio. • In some medical areas, such as intensive care units or surgery, the implementation of the conference on mortality and morbidity is more useful for assessing procedures at high risk of errors. • The implementation of existing databases with data deriving from the systematic review of medical records and in-hospital deaths appears to be desirable. • Mortality Review Committees can represent a very useful tool for all the health facilities for the reduction of preventable deaths, such as those related to HAI.

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