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Mortality rates. Dead confusing.

Brian Jarman¹, Alex Bottle, Paul Aylin

¹Imperial College of Science, Technology and Medicine.

The Health Service Journal

|December 5, 2002

Summary

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Hospital mortality rates are debated. Analysis reveals that after adjusting for patient age and length of stay, there is no evidence of bias against hospitals with more geriatric beds or long-stay patients.

Area of Science:

Healthcare quality assessment
Hospital performance metrics

Background:

Disagreement exists regarding the accurate measurement of hospital mortality rates.
Concerns have been raised that hospitals with a high number of geriatric beds and long-stay patients may be unfairly penalized in mortality rate assessments.

Purpose of the Study:

To investigate whether hospital mortality rates are biased against facilities with a high proportion of geriatric beds or long-stay patients.
To analyze the impact of patient demographics and length of stay on observed mortality rates.

Main Methods:

Analysis of death rates across English National Health Service (NHS) trusts.
Standardization of mortality rates for patient age group and length of stay.

Main Results:

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Mortality rates were found to vary based on length of stay.
After standardization for age and length of stay, adjusted mortality rates showed no significant bias against hospitals with more geriatric beds.
Adjusted mortality rates also showed no bias against hospitals with a higher percentage of patients staying longer than 28 days.

Conclusions:

Standardization for age group and length of stay effectively addresses concerns about bias in hospital mortality reporting.
The findings suggest that current methods, when properly adjusted, do not unfairly disadvantage hospitals serving elderly populations or those with complex patient cases.