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Science

Hospital death rate dropping, report shows

Canadian hospitals are improving the chances that patients will survive, new statistics suggest.

Canadian hospitals are improving the chances that patients will survive, new statistics suggest.

Thehospital standardized mortality ratio (HSMR)data released by theCanadian Institute of Health Information(CIHI) shows that nationally, the rate of in-hospital deaths has fallen four per cent over the past year, said Dr. Indra Pulcins, director ofindicator and performance measurement at the group.

While the datashows some hospitals and health regions have made progress in cutting patient mortality, there are variations by hospital and region. Nonetheless, the trend is down.

"The bar gets lower every day," Pulcins said.

Amongthe76 large acute-care hospitalsor hospital corporationsacross Canada (excluding Quebec, where the data is collected differently), 47 reported drops, two were unchanged and 25 reported increases.

CIHI says the data should not be usedto compare hospitals because of the different factors involved, but "provides an important starting point for hospitals and health regions to assess their mortality rates and identify areas for improvement."

But even hospitals that are below the national average of can improve, Pulcins said. And CIHI would also like the variation between hospitals and health regions to drop.

Hospital mortality ratio

The hospital standardized mortality ratiois a statistic showing the number of deaths that occurred in a hospital or health region divided by the number of deaths expected, times 100.An HSMR greater than 100 suggests thatthe hospital or region's mortality rate is higher than thenational average; under 100, that it is lower.

The HSMRfocuses on thepeople with ailmentsthat account for the majority of in-hospital deaths. It's adjusted totake age, sex, length of stay, admission category, diagnosis and other factors into account.

CIHI cited Ontario'sScarborough General Hospital inthe Greater Toronto Area as a success story. The HSMRdeclined from 125 in 2005-06 to 109 in 2007-08. A number over 100 suggests that the hospital has a mortality rate over the national average.

Scarborough Generaladopted "a culture of patient safety" including cutting adverse drug reactions and surgical infections after the first public release of HSMR data lastyear, CIHI said in a news release Thursday.

"Unfortunately, sometimes it takes something very dramatic to get people's attention focused in the right direction," Dr. Steven Jackson, chief of staff at the hospital, said in the release. There are still things the hospital can do better, "but the HSMR initiative has helped motivate people to take this on."

It's not just mortality rates that can be improved, Pulcins said. "A number of years ago, it was thought impossible to prevent pneumonia" among patients on respirators, but now some hospitals go for months without a case.

HSMR rates for some urban areas, 2007-08 and 2004-05
Health region No. of hospitals/corporations Rate '07-'08 Rate '04-'05
Vancouver 10 83 98
Calgary 11 88 87
Winnipeg 7 105 115
Toronto 6 97 96
Halifax 6 93 125
St. John's 8 102 114
Source: CIHI