title: Intra-hospital correlations among 30-day mortality rates in 18 different clinical and surgical settings.
abstract: OBJECTIVE
  To examine whether a correlation exists in hospitals among 30-day mortality rates for different types of hospitalizations.
  
  
  METHODS
  Cross-sectional study of hospital care based on publically available Italian data from the National Outcome Evaluation Program Edition 2015 of the Italian Agency for Regional Health Services.
  
  
  METHODS
  Patients hospitalized with a diagnosis of congestive heart failure, acute myocardial infarction, chronic renal failure, chronic obstructive pulmonary disease exacerbation, femoral neck fracture, ischemic stroke and non-variceal upper gastrointestinal bleeding, or those who underwent isolated cardiac valve procedure, isolated coronary artery bypass graft surgery, non-ruptured abdominal aortic aneurysm repair and interventions for the following tumors: colon, kidney, brain, lung, stomach, rectal, liver or pancreatic cancer.
  
  
  METHODS
  Condition-specific 30-day crude and risk-adjusted mortality rates.
  
  
  RESULTS
  A total of 808 280 admissions were reported from 844 institutions (median of 4 conditions evaluated per hospital; interquartile range 2-8). Volumes and outcome varied by clinical and surgical conditions across hospitals. Out of 153 pairs of different conditions, 41 were statistically significant in terms of concordance with crude mortality rates and 44 for their adjusted values. The hospital mean percentile rank for 30-day mortality, a composite measure that summarized the multiple indicators, increased significantly alongside number of conditions per hospital with a significant reduction of mortality when most of the studied conditions were treated in the same hospital.
  
  
  CONCLUSIONS
  The variability in 30-day mortality rates at hospital level and the correlation between risk mortality rates suggest that there may be common hospital-wide factors influencing short-term mortality.
authors.affiliation: Division of Cardiology and Cardiac Rehabilitation, "S. Maugeri" Foundation, IRCCS, Institute of Cassano delle Murge, Via per Mercadante km 2, 70020 Cassano delle Murge, Bari, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Guida
authors.affiliation: Cardiology Unit, Cardiothoracic Department, Policlinic University Hospital, Piazza Giulio Cesare 11, 70124, Bari, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Iacoviello
authors.affiliation: Division of Cardiology and Cardiac Rehabilitation, "S. Maugeri" Foundation, IRCCS, Institute of Cassano delle Murge, Via per Mercadante km 2, 70020 Cassano delle Murge, Bari, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Passantino
authors.affiliation: Division of Cardiology and Cardiac Rehabilitation, "S. Maugeri" Foundation, IRCCS, Institute of Cassano delle Murge, Via per Mercadante km 2, 70020 Cassano delle Murge, Bari, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Scrutinio
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D017052:Hospital Mortality; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D013514:Surgical Procedures, Operative / Q000401:mortality*
keywords: correlation of data; mortality; risk