[High hospital standardized mortality ratio does not always indicate low quality].

Hospital standardized mortality ratio (HSMR) is increasingly used to assess quality of care. At Frederiksberg Hospital HSMR increased significantly during the first and second quarter in 2012. We therefore reviewed records of all deceased, including patients deceased during the comparative period in 2011 (n = 413). Information about cancer and infection with Clostridium difficile was specifically noted. We found that the increasing HSMR reflected an increase in the number of terminal cancer patients. Thus, insufficient adjustment for a change in case-mix explained the higher HSMR.

[Analysis of quality data based on national clinical databases]. / Analyse af kvalitetsdata baseret på landsdaekkende kliniske databaser.

There is little agreement on the philosophy of measuring clinical quality in health care. How data should be analyzed and transformed to healthcare information is an ongoing discussion. To accept a difference in quality between health departments as a real difference, one should consider to which extent the selection of patients, random variation, confounding and inconsistency may have influenced results. The aim of this article is to summarize aspects of clinical healthcare data analyses provided from the national clinical quality databases and to show how data may be presented in a way which is understandable to readers without specialised knowledge of statistics.