A methodology for measuring clinical outcomes in an acute care teaching hospital

The purpose of this study was to assess risk-adjusted outcomes following renal failure, gastrointestinal haemorrhage, stroke, myocardial infarction and heart failure. Length of stay, death and unplanned readmission were compared by treating medical unit adjusting for the four risk factors: severity, comorbidity, sex and age. A significant difference in risk-adjusted deaths and length of stay occurred among units treating heart failure, in length of stay among units treating renal failure, and in deaths among units treating gastrointestinal haemorrhage. A significant difference in death, length of stay and unplanned readmission occurred among units treating stroke. No significant difference in outcomes occurred among units treating myocardial infarction. Outcomes were predicted by age, severity and comorbidity. In conclusion, severity and comorbidity together with age were shown to be good predictors of outcomes. The methodology is considered unsuitable as a regular quality assurance activity.