Overall in-Hospital Mortality Compared to Diagnosis Related Mortality

AIM: For a data set of 670 000 inpatient cases, in-hospital mortality was available as well as diagnosis-related mortality which is defined by certain quality indicators. The relationship between diagnosis-related mortality and the overall mortality was analyzed in an explorative way. METHODS: Administrative data form six tertiary centers and three years, respectively, were available for mortality analyses. Quality indicators derived from this data set were analyzed using commercially available software. The indicators were those form the Agency for Healthcare Research and Quality (Patient Safety Indicators) and from HELIOS Kliniken, a privately owned group of German hospitals (HELIOS 2 nd generation indicators). Ranks were defined for in-hospital mortality and for those quality indicators which describe a death rate. Ranks were then aggregated to form rank sums using clinical criteria. RESULTS: The best correlation between the rank of hospital mortality and indicator-based aggregated letality was found for those quality indicators (QI) which describe the ”basic” hospital care. The respective correlations for QI from ”specialized” or ”overall” hospital care were weak. CONCLUSION: When analyzing mortality differences between hospitals (or between subsequent years for a single hospital), quality indicators should be analyzed separately according to the classification described here.