2009-12-21 The Hospital Standardized Mortality Ratio (HSMR) The Hospital Standardized Mortality Ratio (HSMR) is a “big dot” summary measure that is used to track a hospital’s mortality rate over time. The HSMR is a tool that allows hospitals to measure and monitor their progress in quality of care.
The HSMR is the ratio of actual (observed) deaths to expected deaths. It focuses on the diagnosis groups that account for the majority of in-hospital deaths. Using a logistic regression model, it is adjusted for several factors that affect in-hospital mortality, including age, sex, length of stay, admission category, diagnosis group, co-morbidity and transfer from another acute care institution.
An HSMR equal to 100 suggests that there is no difference between a local mortality rate and the average national experience, given the types of patients cared for. An HSMR greater or less than 100 suggests that a local mortality rate is higher or lower than the national experience, respectively.
The HSMR is most useful to individual hospitals to track their own mortality trends. While the HSMR takes into consideration many of the factors associated with the risk of dying, it cannot adjust for every factor. It is important to note that the HSMR is not designed for comparisons between hospitals.
The HSMR does not provide a specific measure of preventable deaths.
The HSMR for Grey Bruce Health Services was 98 in 2008-09. It was 101 for 2007-08; 111 for 2006-07; 101 for 2005-06 and 97 for 2004-05. This total encompasses all the GBHS hospitals, which are located in Lion’s Head, Markdale, Meaford, Owen Sound, Southampton and Wiarton.
The average for the South West Local Health Integration Network, of which GBHS is a part, was 103 in 2008-09; 101 in 2007-08; 113 in 2006-07; 109 in 2005-06 and 103 in 2004-05.
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