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. 2020 Jan;25(1):13-21.
doi: 10.1177/1355819619847689. Epub 2019 Sep 18.

What is the relationship between mortality alerts and other indicators of quality of care? A national cross-sectional study

Elizabeth Cecil  1 , Alex Bottle  2 , Aneez Esmail  3 , Charles Vincent  4 , Paul Aylin  5
Affiliations

What is the relationship between mortality alerts and other indicators of quality of care? A national cross-sectional study

Elizabeth Cecil et al. J Health Serv Res Policy. 2020 Jan.

Abstract

Objectives: To assess whether mortality alerts, triggered by sustained higher than expected hospital mortality, are associated with other potential indicators of hospital quality relating to factors of hospital structure, clinical process and patient outcomes.

Methods: Cross-sectional study of National Health Service hospital trusts in England (2011–2013) using publicly available hospital measures reflecting organizational structure (mean acute bed occupancy, nurse/bed ratio, training satisfaction and proportion of trusts with low National Health Service Litigation Authority risk assessment or in financial deficit); process (mean proportion of eligible patients who receive percutaneous coronary intervention within 90 minutes) and outcomes (mean patient satisfaction scores, summary measures of hospital mortality and proportion of patients harmed). Mortality alerts were based on hospital administrative data.

Results: Mortality alerts were associated with structural indicators and outcome indicators of quality. There was insufficient data to detect an association between mortality alerts and the process indicator.

Conclusions: Mortality alerts appear to reflect aspects of quality within an English hospital setting, suggesting that there may be value in a mortality alerting system in highlighting poor hospital quality.

Keywords: hospital mortality; indicators of hospital quality; surveillance system.

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References

    1. Spiegelhalter DJ. Surgical audit: statistical lessons from Nightingale and Codman. J R Stat Soc Ser A Stat Soc 1999; 162: 45–58.
    1. Hartz AJ, Krakauer H, Kuhn EM, et al. Hospital characteristics and mortality rates. N Engl J Med 1989; 321: 1720–1725. - PubMed
    1. NHS Digital. Home page. URL: http://content.digital.nhs.uk/home (accessed 1 November 2018).
    1. Francis R. Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry – executive summary. London: The Stationery Office, 2013.
    1. Mohammed MA, Lilford R, Rudge G, et al. The findings of the Mid-Staffordshire Inquiry do not uphold the use of hospital standardized mortality ratios as a screening test for ‘bad’ hospitals. QJM 2013; 106: 849. - PubMed

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