League tables are inaccurate in ranking hospital mortality outcomes
The UK government wants to publish league tables of hospital
outcomes to help monitor services and spread best practices in the NHS.
However, on p 1931 Parry et al show that league tables are unreliable
in comparing outcomes such as mortality. They ranked nine neonatal
intensive care units in annual league tables by hospital mortality over
6 years. Even after adjusting for case mix, individual rankings
fluctuated wildly from year to year. Amalgamating league tables over
several years may pinpoint the most successful hospitals but will not
identify best practices. For that, prospective cohort studies are
needed to test specific hypotheses.
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- Annual league tables of mortality in neonatal intensive care units: longitudinal study
- Gareth J Parry, Craig R Gould, Chris J McCabe, and William O Tarnow-Mordi
BMJ 1998 316: 1931-1935.[Abstract] [Full Text] [PDF]
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