• Am J Med Qual · May 2010

    Mortality rates as a measure of quality and safety, "caveat emptor".

    • Robert Klugman, Lisa Allen, Evan M Benjamin, Janice Fitzgerald, and Walter Ettinger.
    • University of Massachusetts Medical School, Worcester, MA, USA. robert.klugman@umassmemorial.org
    • Am J Med Qual. 2010 May 1;25(3):197-201.

    AbstractThe objective of this study was to demonstrate the impact of a single ICD-9 (International Statistical Classification of Diseases and Related Health Problems, Version 9) code on the observed-to-expected mortality ratios for acute care hospitals, calculated using administrative data. The study was a retrospective analysis of mortality data and prospective measurement of the impact of a change in coding on expected mortality rates. Measurement included overall mortality observed-to-expected mortality index for 2 hospitals and rate of use of the palliative care ICD-9 code. The main result was that both retrospective and prospective applications of this single ICD-9 code significantly reduced observed-to-expected mortality ratios. Both regulators and hospitals need to be aware of the impact of the quality of coding on publicly reported quality and patient safety data.

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