ArticleBMJ (Clinical research ed.)2013
Including post-discharge mortality in calculation of hospital standardised mortality ratios: retrospective analysis of hospital episode statistics.
Article in BMJ (Clinical research ed.), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
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Who cites it
29 citing papers in PubMed.
- Predicting six-month mortality of patients with traumatic brain injury: usefulness of common intensive care severity scores.Critical care (London, England) · 2014Trial
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- In-hospital versus postdischarge 30-day mortality in patients admitted after acute myocardial infarction (AMI), cerebral stroke or hip fracture: a cohort study based on registry data.BMJ open quality · 2025Article
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- Risk Prediction Models for Hospital Mortality in General Medical Patients: A Systematic Review.American journal of medicine open · 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
- One-year Mortality of Cancer Patients with an Unplanned ICU Admission: A Cohort Analysis Between 2008 and 2017 in the Netherlands.Journal of intensive care medicine · 2022Article
- A detailed analysis of patients included in the Summary Hospital-level Mortality Indicator (SHMI) for myocardial infarction (MI)-all is not what it seems?BMJ open quality · 2020Article
- Hospitals´ Discharge Tendency and Risk of Death - An Analysis of 60,000 Norwegian Hip Fracture Patients.Clinical epidemiology · 2020Article
- Data resource profile: State Inpatient Databases.International journal of epidemiology · 2019Article
- Observational
- Nonparametric change point estimation for survival distributions with a partially constant hazard rate.Lifetime data analysis · 2019Article
- Evaluation of hospital outcomes: the relation between length-of-stay, readmission, and mortality in a large international administrative database.BMC health services research · 2018Article
- Article
- Prognosis of Treatment Outcomes by Cognitive and Physical Scales.Open medicine (Warsaw, Poland) · 2018Article
- Impact of Public Reporting of 30-day Mortality on Timing of Death after Coronary Artery Bypass Graft Surgery.Anesthesiology · 2017Article
- Use of Electronic Health Record Data to Evaluate the Impact of Race on 30-Day Mortality in Patients Admitted to the Intensive Care Unit.Journal of racial and ethnic health disparities · 2017Article
- Chronic Obstructive Pulmonary Disease Readmissions and Other Measures of Hospital Quality.American journal of respiratory and critical care medicine · 2017Article
- Reduced length of hospital stay through a point of care placed automated blood culture instrument.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2017Article
- Unconscious trauma patients: outcome differences between southern Finland and Germany-lesson learned from trauma-registry comparisons.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2016Article
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5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo assess the consequences of applying different mortality timeframes on standardised mortality ratios of individual hospitals and, secondarily, to evaluate the association between in-hospital standardised mortality ratios and early post-discharge mortality rate, length of hospital stay, and transfer rate.
designRetrospective analysis of routinely collected hospital data to compare observed deaths in 50 diagnostic categories with deaths predicted by a case mix adjustment method.
setting60 Dutch hospitals.
participants1 228 815 patients discharged in the period 2008 to 2010.
main outcome measuresIn-hospital standardised mortality ratio, 30 days post-admission standardised mortality ratio, and 30 days post-discharge standardised mortality ratio.
resultsCompared with the in-hospital standardised mortality ratio, 33% of the hospitals were categorised differently with the 30 days post-admission standardised mortality ratio and 22% were categorised differently with the 30 days post-discharge standardised mortality ratio. A positive association was found between in-hospital standardised mortality ratio and length of hospital stay (Pearson correlation coefficient 0.33; P=0.01), and an inverse association was found between in-hospital standardised mortality ratio and early post-discharge mortality (Pearson correlation coefficient -0.37; P=0.004).
conclusionsApplying different mortality timeframes resulted in differences in standardised mortality ratios and differences in judgment regarding the performance of individual hospitals. Furthermore, associations between in-hospital standardised mortality rates, length of stay, and early post-discharge mortality rates were found. Combining these findings suggests that standardised mortality ratios based on in-hospital mortality are subject to so-called "discharge bias." Hence, early post-discharge mortality should be included in the calculation of standardised mortality ratios.
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