Dataset Information

Canadian in-hospital mortality for patients with emergency-sensitive conditions: a retrospective cohort study.

ABSTRACT:

Background

The emergency department (ED) sensitive hospital standardized mortality ratio (ED-HSMR) measures risk-adjusted mortality for patients admitted to hospital with conditions for which ED care may improve health outcomes. This study aimed to describe in-hospital mortality across Canadian provinces using the ED-HSMR.

Methods

Hospital discharge data were analyzed from April 2009 to March 2012. The ED-HSMR was calculated as the ratio of observed deaths among patients with emergency-sensitive conditions in a hospital during a year (2010-11 or 2011-12) to the expected deaths for the same patients during the reference year (2009-10), multiplied by 100. The expected deaths were estimated using predictive models fitted from the reference year. Aggregated provincial ED-HSMR values were calculated. A HSMR value above or below 100 respectively means that more or fewer deaths than expected occurred within a province.

Results

During the study period, 1,335,379 patients were admitted to hospital in Canada with an emergency-sensitive condition as the most responsible diagnosis. More in-hospital deaths (95% confidence interval) than expected were respectively observed for the years 2010-11 and 2011-12 in Newfoundland [124.3 (116.3-132.6); & 117.6 (110.1-125.5)] and Nova Scotia [116.4 (110.7-122.5) & 108.7 (103.0-114.5)], while mortality was as expected in Prince Edward Island [99.9 (86.5-114.8) & 100.7 (87.5-115.3)] and Manitoba [99.2 (94.5-104.1) & 98.3 (93.5-103.3)], and less than expected in all other provinces and territories.

Conclusions

Our study revealed important variation in risk-adjusted mortality for patients admitted to hospital with emergency-sensitive conditions among Canadian provinces. The ED-HSMR may be a useful outcome indicator to complement existing process indicators in measuring ED performance.

Trial registration

N/A - Retrospective cohort study.

SUBMITTER: Berthelot S

PROVIDER: S-EPMC6805639 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Publications

Canadian in-hospital mortality for patients with emergency-sensitive conditions: a retrospective cohort study.

Berthelot Simon S Lang Eddy S ES Quan Hude H Stelfox Henry T HT

BMC emergency medicine 20191022 1

<h4>Background</h4>The emergency department (ED) sensitive hospital standardized mortality ratio (ED-HSMR) measures risk-adjusted mortality for patients admitted to hospital with conditions for which ED care may improve health outcomes. This study aimed to describe in-hospital mortality across Canadian provinces using the ED-HSMR.<h4>Methods</h4>Hospital discharge data were analyzed from April 2009 to March 2012. The ED-HSMR was calculated as the ratio of observed deaths among patients with emer ...[more]

PMID: 31640561

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Dataset Information

Canadian in-hospital mortality for patients with emergency-sensitive conditions: a retrospective cohort study.

Background

Methods

Results

Conclusions

Trial registration

Publications

Canadian in-hospital mortality for patients with emergency-sensitive conditions: a retrospective cohort study.

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