Letters

What hospital mortality league tables tell you

BMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7403.1397-b (Published 19 June 2003) Cite this as: BMJ 2003;326:1397
  1. Paul Aylin, assistant director (p.aylin@imperial.ac.uk),
  2. Sir Brian Jarman, Director (b.jarman@imperial.ac.uk),
  3. Tim Kelsey, chief executive
  1. Dr Foster Unit at Imperial Department of Epidemiology and Public Health, Imperial College London, St Mary's Campus, London W2 1PG
  2. Dr Foster Unit at Imperial Department of Epidemiology and Public Health, Imperial College London, St Mary's Campus, London W2 1PG
  3. Dr Foster Limited, Sir John Lyon House, London EC4V 3NX

    EDITOR—Jacobson et al take issue with Dr Foster's publication of mortality league tables and pose four main questions.1

    Firstly, they ask what the data mean, citing changes in the type of care provided in hospitals. Hospital standardised mortality ratios were designed to be a robust measure of in-hospital mortality, taking into account differences in patient mix with explicit adjustment for 80 different diagnoses, admission method, age, sex, and length of stay. We found that after adjustment, death rates show no bias …

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