Published 2 April 2009, doi:10.1136/bmj.b1356
Cite this as: BMJ 2009;338:b1356

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Measuring quality

The first 150 words of the full text of this article appear below.

"How long does it take the health care system to kill 500 people?" asked Ross Wilson at the Quality Forum in Berlin two weeks ago (you can watch the video of his talk, and others, at http://internationalforum.bmj.com). His point was that we just don’t know. The global airline industry is able to say how many passengers die each year (500 in 2007) and why. By comparison, health care is flying blind.

Part of the problem is that we can’t agree on which data to collect or how to interpret them. This week Mohammed Mohammed and colleagues (doi:10.1136/bmj.b780) report their analysis of hospital standardised mortality ratios (HSMRs) in the West Midlands. They looked at two variables—co-morbidity and emergency admissions—used to adjust the ratios for differences in case mix at different hospitals. Because these variables can be affected by systematic differences in how hospitals code patients or decide which . . . [Full text of this article]

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