Intended for healthcare professionals


Review rejects claim of higher hospital death rates in England than in US

BMJ 2015; 350 doi: (Published 10 February 2015) Cite this as: BMJ 2015;350:h787
  1. Jacqui Wise
  1. 1London

Hospital standardised mortality ratios (HSMRs) are an unreliable method for comparing the quality of hospitals in the United States and England, an investigation by the Academy of Medical Royal Colleges has concluded.1

The independent inquiry was commissioned after Brian Jarman, former professor of primary care at Imperial College London, who developed the HSMR index, said in media reports in September 2013 that the likelihood of dying in NHS hospitals in England was 45% higher than in hospitals in the United States.2 His claim, made on Channel 4 news and repeated in many newspapers, came soon after 11 hospitals had been put into special measures and shortly after Robert Francis QC’s report into failings in care at Staffordshire Hospital.

Jarman’s HSMR is the actual number of deaths at a hospital divided by the expected number of deaths over the same period, multiplied by 100. Scores are published annually in the Hospital Guide produced by the …

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