[Hospital standardised mortality ratios based on data from administrative registries. A pilot project].
BACKGROUND
Hospital standardised mortality ratios (HSMR) are widely used in quality improvement campaigns. No data exist on whether HSMR can be computed based on Danish administrative registries. We therefore used data from Danish registries to compute HSMRs.


METHODS
By linking hospital discharge registries with the Danish Civil Registration System, we identified 77 primary discharge diagnoses that accounted for 80% of all deaths within 30 days of admission. We calculated overall death rates stratified by the 77 primary discharge diagnoses, age, gender, and type of admission and used these to compute the expected number of deaths. HSMR for each hospital was calculated as the ratio of observed to expected number of deaths.


RESULTS
Pneumonia, non-specified was the diagnosis that accounted for most deaths within 30 days after admission. The crude mortality rate varied from 5.7% to 6.3%. HSMR varied little--from 95 and 98 in Hospitals B and D to 102 and 103 in Hospitals A and C, respectively.


CONCLUSIONS
We found that it was possible to use data from Danish administrative registries to compute HSMR and that HSMR varied little between hospitals with comparable case-mixes.
Christensen
Steffen
S
Klinisk Epidemiologisk Afdeling, Arhus Sygehus, DK-8000 Arhus C. sc@dce.au.dk
Jacobsen
Jacob
J
Bartels
Paul
P
Nørgaard
Mette
M
D002423:Cause of Death; D003718:Denmark / Q000453:epidemiology; D003953:Diagnosis-Related Groups; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data; D010865:Pilot Projects; D011014:Pneumonia / Q000401:mortality; D011785:Quality Assurance, Health Care; D012042:Registries; D013997:Time Factors