Systems for Comparing Actual and Predicted Mortality Rates: Characteristics To Promote Cooperation in Improving Hospital Care

Editorials15 May 1993Systems for Comparing Actual and Predicted Mortality Rates: Characteristics To Promote Cooperation in Improving Hospital CareHarry P. Selker, MD, MSPHHarry P. Selker, MD, MSPHNew England Medical Center, Tufts University School of Medicine, Boston, MA 02111.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-118-10-199305150-00010 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Mortality rates have been increasingly proposed as a measure of quality of hospital care. However, in themselves, mortality rates, whether used alone or in conjunction with severity-adjusted predicted rates, will not improve care. Only appropriate responses to mortality rates by clinicians, hospital administrators, consumers, and health care payers will improve care. For severity-adjusted mortality predictors to have their desired effect, they must have characteristics attractive to all of these groups. These characteristics are listed in this editorial.During the past decade, mortality rates have been increasingly proposed as a measure of quality of hospital care. In 1986, the federal government ...References1. U.S. Health Care Financing Administration. Medicare hospital mortality information. Washington, DC; Government Printing Office; 1987. Google Scholar2. U.S. Health Care Financing Administration. Medicare hospital mortality information. Washington, DC; Government Printing Office; 1988. Google Scholar3. Green J, Wintfeld N, Sharkey P, Passman LJ. The importance of severity of illness in assessing hospital mortality. JAMA. 1990; 263: 241-6. Google Scholar4. Berwick DM, Wald DL. Hospital leaders' opinions of the HCFA mortality data. JAMA. 1990; 263:247-9. Google Scholar5. Park RE, Brook RH, Kosecoff J, Keesey J, Rubenstein L, Keeler E, et al. 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Inquiry. 1985; 12:377-87. Google Scholar22. Horn SD, Horn RA. The Computerized Severity Index. A new tool for case-mix management. J Med Syst. 1986; 10:73-78. Google Scholar23. Selker HP. Coronary care unit triage decision aids: how do we know when they work? (Editorial). Am J Med. 1989; 87:491-93. Google Scholar Author, Article, and Disclosure InformationAuthors: Harry P. Selker, MD, MSPHAffiliations: New England Medical Center, Tufts University School of Medicine, Boston, MA 02111.Corresponding Author: Harry P. Selker, MD, MSPH, Center for Cardiovascular Health Services Research, New England Medical Center, 1031, 750 Washington Street, Boston, MA 02111. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoVariations in Mortality and Length of Stay in Intensive Care Units William A. Knaus , Douglas P. Wagner , Jack E. Zimmerman , and Elizabeth A. Draper Metrics Cited byThe Predictive Approaches to Treatment effect Heterogeneity (PATH) StatementDavid M. 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