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Mortality rates are an unreliable metric for assessing hospital quality, study finds
Date:12/22/2010

BOSTON (December 22, 2010) -- Is quality in the eye of the beholder?

Researchers at Harvard Medical School and Massachusetts General Hospital have found wide disparities among four common measures of hospital-wide mortality rates, with competing methods yielding both higher- and lower-than-expected rates for the same Massachusetts hospitals during the same year.

The findings, published Dec. 23 in a special article in the New England Journal of Medicine, stoke a simmering debate over the value of hospital-wide mortality rates as a yardstick for health care quality. The measure, which compares a hospital's actual patient death rate to statistical predictions, is reported publicly in countries including England, Canada and Denmark, but some hospitals and policy experts have questioned its value due to the complexity and variability of diagnoses.

"It's troubling that four different methods for calculating hospital mortality rates as a measure of quality should yield such different results," said lead author David M. Shahian, HMS professor of surgery at Massachusetts General Hospital. "Measurement theorynot to mention plain common sensesuggests there is a problem."

The potential of performance evaluation to improve both the quality and the cost of health care has fueled interest in provider "report cards," including mandates by state and federal law.

In 2008, the Massachusetts Division of Health Care Finance and Policy engaged researchers Shahian; Lisa I. Iezzoni, HMS professor of medicine at Mass General; and Sharon-Lise T. Normand, HMS professor of health care policy (biostatistics) and professor in the Department of Biostatistics at Harvard School of Public Health, to evaluate four vendor-created measures of hospital-wide mortality. The state was looking for a means to measure hospital quality for the public report cards mandated under its 2006 health care reform law.

The researchers compared four measures o
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Contact: Katie DuBoff
communications@hms.harvard.edu
617-432-0442
Harvard Medical School
Source:Eurekalert

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