ArticleBMJ quality & safety2012
Case-mix adjusted hospital mortality is a poor proxy for preventable mortality: a modelling study.
Article in BMJ quality & safety, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Ranking Hospitals Based on Preventable Hospital Death Rates: A Systematic Review With Implications for Both Direct Measurement and Indirect Measurement Through Standardized Mortality Rates.The Milbank quarterly · 2019Pooled it
- Factors associated with regional differences in healthcare quality for patients with acute myocardial infarction in Japan.PloS one · 2025Article
- [Hospital standardized mortality ratio: limits and potential of the indicator for assessing hospital performance in the Brazilian Unified National Health System].Cadernos de saude publica · 2024Article
- Article
- Weekend Mortality in an Italian Hospital: Immediate versus Delayed Bedside Critical Care Treatment.International journal of environmental research and public health · 2022Article
- A narrative account of the key drivers in the development of the Learning from Deaths policy.Journal of health services research & policy · 2021Article
- Reducing hospital mortality: Incremental change informed by structured mortality review is effective.Future healthcare journal · 2020Article
- Risk Aversion in Cardiac Surgery: 15-Year Trends in a Statewide Analysis.The Annals of thoracic surgery · 2020Article
- Observational
- Article
- Hospital quality measures: are process indicators associated with hospital standardized mortality ratios in French acute care hospitals?BMC health services research · 2017Article
- Article
- Reviewing deaths in British and US hospitals: a study of two scales for assessing preventability.BMJ quality & safety · 2017Article
- The prevalence of potentially preventable deaths in an acute care hospital: A retrospective cohort.Medicine · 2017Observational
- From research to practice: results of 7300 mortality retrospective case record reviews in four acute hospitals in the North-East of England.BMJ open quality · 2017Article
- Avoidability of hospital deaths and association with hospital-wide mortality ratios: retrospective case record review and regression analysis.BMJ (Clinical research ed.) · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
Risk-adjustment schemes are used to monitor hospital performance, on the assumption that excess mortality not explained by case mix is largely attributable to suboptimal care. We have developed a model to estimate the proportion of the variation in standardised mortality ratios (SMRs) that can be accounted for by variation in preventable mortality. The model was populated with values from the literature to estimate a predictive value of the SMR in this context-specifically the proportion of those hospitals with SMRs among the highest 2.5% that fall among the worst 2.5% for preventable mortality. The extent to which SMRs reflect preventable mortality rates is highly sensitive to the proportion of deaths that are preventable. If 6% of hospital deaths are preventable (as suggested by the literature), the predictive value of the SMR can be no greater than 9%. This value could rise to 30%, if 15% of deaths are preventable. The model offers a 'reality check' for case mix adjustment schemes designed to isolate the preventable component of any outcome rate.
Indexed as
Identifiers
What OpenQuestion holds
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.