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Journal Article > Study
Shahian DM, Wolf RE, Iezzoni LI, Kirle L, Normand SL. N Engl J Med. 2010;363:2530-2539.
Hospital-wide mortality rates are widely used as a marker of health care quality, but it remains unclear how to most accurately measure them. In this classic study, investigators provided standard hospital discharge data to four vendors who independently calculated hospital mortality rates. These methods produced varying rates of hospital mortality, and classification of hospitals as either higher or lower than average differed depending on the estimation method. These findings demonstrate that in-hospital mortality remains difficult to estimate and underscore the need for caution in considering it a marker of hospital care quality.
Mills DH, ed. Report on the medical insurance feasibility study / sponsored jointly by California Medical Association and California Hospital Association. San Francisco, CA: Sutter Publications, Inc.; 1977.
Escalating professional liability costs prompted this study on the nature of adverse outcomes related to medical care. Findings showed that incident rates were low, but also that risks were a part of medical care, and not all of them were associated with legal fault. In addition, the resulting work provided an initial set of classifications, nomenclature, and evaluation techniques that were seen by the authors to assist in creating a more efficient patient compensation program. (A summary of the report was published as Mills DH. Medical insurance feasibility study. A technical summary. West J Med. 1978;128:360-365.)