title: One-year mortality after a first visit to a cardiology outpatient clinic: a useful performance indicator?
abstract: OBJECTIVE
  In 2003 the Dutch Health Care Inspectorate introduced performance indicators to monitor and compare quality of care in Dutch hospitals. In 2007, the new performance indicator 'one-year mortality after a first visit to a cardiology outpatient clinic' was introduced. We set out to evaluate this new indicator in three Dutch teaching hospitals.
  
  
  METHODS
  Using electronic medical records, information was collected retrospectively of patients aged >/=70 years who visited the cardiology outpatient clinic of Medical Centre Alkmaar, Meander Medical Centre Amersfoort and Deventer Hospital between 1 January 2006 and 31 January 2006. Diagnoses were based on the diagnosis treatment combination (DBC) coding system.
  
  
  RESULTS
  547 patients (mean age 78.0 years, 53% men) were included, 35 (6.4%) of whom had died after one year. Cardiovascular disease was the most frequent cause of death (22/35, 62.9%). The oneyear mortality among the three hospitals varied from 5.0 to 7.3% (NS).
  
  
  CONCLUSIONS
  One-year mortality after the first visit to a cardiology outpatient clinic amounted to 6.4% in patients aged >/=70 years and did not differ significantly between the three Dutch teaching hospitals. The administrative load to obtain the necessary information was considerable. One-year mortality should be regarded as an 'outcome' parameter rather than a 'performance' indicator. (Neth Heart J 2009;17:52-5.).
authors.affiliation: Departments of Cardiology, Meander Medical Centre, Amersfoort and University Medical Centre Utrecht, the Netherlands.
authors.forename: M I F J
authors.initials: MI
authors.lastname: Oerlemans
authors.forename: D J A
authors.initials: DJ
authors.lastname: Lok
authors.forename: J H
authors.initials: JH
authors.lastname: Cornel
authors.forename: A
authors.initials: A
authors.lastname: Mosterd