The use of hospital mortality rates as a measure of quality has been gaining support over recent years.

On the surface, mortality rates appear to be a good measure – it is unambiguous whether a patient died or not, and death is not the desired outcome of medical treatment. However, the issue is not as clear-cut as it seems.

A recent paper in the American Journal of Medical Quality, by researchers from 3M and Yale University, assisted by the J. Graham Atkinson, DPhil, Executive Vice President for Research and Policy of the Foundation, raises important issues regarding the measurement and use of mortality rates and points out the importance of focusing on preventable deaths and appropriately risk adjusting.

It also shows that, as they are currently used, random statistical variations can dwarf meaningful differences in death rates.

Richard L Fuller, MS, John S Hughes, MD, Norbert I Goldfield, MD, Graham Atkinson, DPhil, Are We Confident of Across-Hospital Mortality Comparisons?, American Journal of Medical Quality, May 2018.