SynthesisBMC health services research2007
What is the empirical evidence that hospitals with higher-risk adjusted mortality rates provide poorer quality care? A systematic review of the literature.
Synthesis in BMC health services research, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
55 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Do large-scale hospital- and system-wide interventions improve patient outcomes: a systematic review.BMC health services research · 2014Pooled it
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- Diagnostic related groups-based reimbursement in Kazakhstan: Have we learned enough?Journal of public health research · 2025Article
- Comparative clinical outcomes and mortality risk in coronary artery bypass grafting, valve surgeries, and percutaneous interventions.American journal of cardiovascular disease · 2025Article
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- Standardized mortality ratios for regionalized acute cardiovascular care.BMC health services research · 2023Article
- Changes in the Hospital Standardized Mortality Ratio Before and During the COVID-19 Pandemic: A Disaggregated Analysis by Region and Hospital Type in Korea.Journal of preventive medicine and public health = Yebang Uihakhoe chi · 2023Article
- Rate and risk factors of in-hospital and early post-discharge mortality in patients admitted to an internal medicine ward.Clinical medicine (London, England) · 2023Article
- On the correlation between outcome indicators and the structure and process indicators used to proxy them in public health care reporting.The European journal of health economics : HEPAC : health economics in prevention and care · 2021Article
- Observational
- Improving clinical outcomes and patient satisfaction among patients with coronary artery disease: an example of enhancing regional integration between a cardiac centre and a referring hospital.BMC health services research · 2020Article
- What is the relationship between mortality alerts and other indicators of quality of care? A national cross-sectional study.Journal of health services research & policy · 2020Article
- Observational
- Hospital quality measures: are process indicators associated with hospital standardized mortality ratios in French acute care hospitals?BMC health services research · 2017Article
- Article
- Variation in and risk factors for paediatric inpatient all-cause mortality in a low income setting: data from an emerging clinical information network.BMC pediatrics · 2017Article
- Development and validation of a score for evaluating comprehensive stroke care capabilities: J-ASPECT Study.BMC neurology · 2017Article
- Improving the Estimation of Risk-Adjusted Grouped Hospital Standardized Mortality Ratios Using Cross-Jurisdictional Linked Administrative Data: A Retrospective Cohort Study.Frontiers in public health · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite increasing interest and publication of risk-adjusted hospital mortality rates, the relationship with underlying quality of care remains unclear. We undertook a systematic review to ascertain the extent to which variations in risk-adjusted mortality rates were associated with differences in quality of care.
methodsWe identified studies in which risk-adjusted mortality and quality of care had been reported in more than one hospital. We adopted an iterative search strategy using three databases--Medline, HealthSTAR and CINAHL from 1966, 1975 and 1982 respectively. We identified potentially relevant studies on the basis of the title or abstract. We obtained these papers and included those which met our inclusion criteria.
resultsFrom an initial yield of 6,456 papers, 36 studies met the inclusion criteria. Several of these studies considered more than one process-versus-risk-adjusted mortality relationship. In total we found 51 such relationships in a widen range of clinical conditions using a variety of methods. A positive correlation between better quality of care and risk-adjusted mortality was found in under half the relationships (26/51 51%) but the remainder showed no correlation (16/51 31%) or a paradoxical correlation (9/51 18%).
conclusionThe general notion that hospitals with higher risk-adjusted mortality have poorer quality of care is neither consistent nor reliable.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.