Letters Hospital mortality comparisons

Hospital standardised mortality rates should not be used to make interhospital comparisons

BMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f6155 (Published 15 October 2013) Cite this as: BMJ 2013;347:f6155
  1. Martin McKee, professor of European public health1
  1. 1London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
  1. martin.mckee{at}lshtm.ac.uk

As Spiegelhalter notes, not knowing which countries are included in Brian Jarman’s analysis makes it difficult to assess their validity.1 However, it is instructive to look at what researchers studying hospital standardised mortality rates (HSMRs) in other countries have concluded.

A Danish study that analysed 2007-11 data could not reconcile the substantial and often sudden changes …

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