Research Associate, Department of Primary Care and Public Health, Imperial College London, UK.
Reader, Dr Foster Unit, Department of Primary Care and Public Health, Imperial College London, UK.
J Health Serv Res Policy. 2020 Jan;25(1):13-21. doi: 10.1177/1355819619847689. Epub 2019 Sep 18.
To assess whether mortality alerts, triggered by sustained higher than expected hospital mortality, are associated with other potential indicators of hospital quality relating to factors of hospital structure, clinical process and patient outcomes.
Cross-sectional study of National Health Service hospital trusts in England (2011–2013) using publicly available hospital measures reflecting organizational structure (mean acute bed occupancy, nurse/bed ratio, training satisfaction and proportion of trusts with low National Health Service Litigation Authority risk assessment or in financial deficit); process (mean proportion of eligible patients who receive percutaneous coronary intervention within 90 minutes) and outcomes (mean patient satisfaction scores, summary measures of hospital mortality and proportion of patients harmed). Mortality alerts were based on hospital administrative data.
Mortality alerts were associated with structural indicators and outcome indicators of quality. There was insufficient data to detect an association between mortality alerts and the process indicator.
Mortality alerts appear to reflect aspects of quality within an English hospital setting, suggesting that there may be value in a mortality alerting system in highlighting poor hospital quality.
评估死亡率警报（由持续高于预期的医院死亡率触发）是否与与医院结构、临床流程和患者结局相关的其他潜在医院质量指标有关。
对英格兰国民保健服务医院信托机构进行的横断面研究（2011-2013 年），使用反映组织结构（平均急性病床占用率、护士/床比、培训满意度和低国民保健服务诉讼局风险评估或财务亏损的信托机构比例）、流程（符合条件的患者在 90 分钟内接受经皮冠状动脉介入治疗的平均比例）和结局（患者满意度评分均值、医院死亡率综合指标和受伤害患者比例）的公开可得的医院指标。死亡率警报基于医院管理数据。
死亡率警报与质量的结构指标和结果指标相关。由于数据不足，无法检测死亡率警报与流程指标之间的关联。
死亡率警报似乎反映了英国医院环境中的某些质量方面，这表明死亡率警报系统在突出不良医院质量方面可能具有价值。
