Death rate measure used to judge hospital quality may be misleading

Hospitals, health insurers and patients often rely on patient death rates in hospitals to compare hospital quality. Now a new study by researchers at Yale School of Medicine questions the accuracy of that widely used approach and supports measuring patient deaths over a period of 30 days from admission even after they have left the hospital.

Published in the Jan. 3 issue of , the study has wide implications as take on more importance in the healthcare system, notes Elizabeth Drye, M.D., a research scientist at Yale School of Medicine's Center for Outcomes Research and Evaluation, who led the research. The study compared two widely used approaches to assessing hospital quality. One approach uses of patients who die during their initial hospitalization, and the other uses rates of patients who die within 30 days, whether or not they have been discharged.

Drye and colleagues focused on mortality rates for patients with heart attack, , and pneumonia. For these conditions, one-third to one-half of deaths within 30 days occur after the patient leaves the hospital, but this proportion often varies by hospital.

"We were concerned that only counting deaths during the initial hospitalization can be misleading," said Drye. "Because some hospitals keep their patients for less time than others due to patient transfers to other facilities or because they send patients home more quickly."

Drye and her colleagues found that quality at many U.S. hospitals looked quite different using the two different accounting methods. The team also found that measures looking only at deaths in the hospital favor hospitals that keep their patients for a shorter length of time.

"To assess current and future patient management strategies," said Drye. "We should assess all patients for a standard time period, such as 30 days."

Drye said the findings have implications for any study that compares hospitals using to judge quality. "We hope the study will inform choices about how we measure quality so that we will be using the best tools for building a higher-quality system," she said.

More information: Annals of Internal Medicine 156:19-26. (January 3, 2012)

add to favorites email to friend print save as pdf

Related Stories

Lower-cost hospital care is not always lower in quality

Feb 22, 2010

The costs that hospitals incur in treating patients vary widely and do not appear to be strongly associated either with the quality of care patients receive or their risk of dying within 30 days, according to a report in ...

Using death rates to judge hospital performance 'a bad idea'

Apr 21, 2010

Mortality rates are a poor measure of the quality of hospital care and should not be a trigger for public inquiries such as the investigation at the Mid Staffordshire hospital, argue experts in a paper published in the British ...

Deaths plague even top hospitals

Aug 08, 2011

More than 120 hospitals given top marks by patients for providing excellent care also have a darker distinction: high death rates for heart attack, heart failure or pneumonia, a USA Today analysis of new Medicare data ...

Recommended for you

US seniors' health poorest, global survey shows

2 hours ago

(HealthDay)— Seniors in America have more chronic health problems and take more medications than seniors in 10 other industrialized countries do, according to a new global survey. The United States also ...

New survey of employers about the health insurance market

4 hours ago

A new nationally representative survey of employers—the largest purchasers of health care in the country— shows that most are unfamiliar with objective metrics of health plan quality information. The survey, conducted ...

Running really can keep you young, study says

7 hours ago

If you are an active senior who wants to stay younger, keep on running. A new study involving the University of Colorado Boulder and Humboldt State University shows that senior citizens who run several times ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.