Interpreting Hospital Mortality Data: How Can We Proceed?

TLDR: This report document and justify some of the design decisions made to assess the impact of the diagnosis related group (DRG)-based prospective payment system (PPS) on the quality of care for hospitalized Medicare patients.

Abstract: DATA about whether patients live or die following short-term—care hospitalization can serve at least two purposes: (1) to determine if hospital performance has improved or deteriorated over time and (2) to determine if performance differs across hospitals at one given time. Hospital mortality figures have been used in this manner primarily because such data are readily available, easy to understand, and potentially important to the public. However, if mortality data are to be used for these purposes, they must reflect actual differences in the quality of care, not other factors, such as patient sickness at admission. We have been studying hospital mortality and other outcomes as part of a clinically detailed national study to assess the impact of the diagnosis related group (DRG)-based prospective payment system (PPS) on the quality of care for hospitalized Medicare patients. In this report we document and justify some of the design decisions we made