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Tuesday 25th October 2016

Death rates poor measure of hospital performance

21st April 2010

Two experts writing in the British Medical Journal have said hospital death rates are a "poor test of quality" and should not be used to measure performance.


Their stance opposes those who feel the Care Quality Commission should pay closer attention to the privately produced Dr Foster death rates.

The two experts, Professor Richard Lilford, from Birmingham University, and Peter Pronovost, from Johns Hopkins University in the US, were critical of how mortality data was employed to criticise Stafford Hospital recently.

The trust has faced heavy fire from patients, the government and the NHS regulator for its "appalling care" which was reported to have potentially caused 400 deaths.

However the experts said the assertions were "precarious" and the use of death rates to measure performance was only being "kept alive by well-meaning decision-makers".

Death rates compiled by companies such as Dr Foster make a calculation about whether death rates at a trust are higher than average after patients' ages and the gravity of their condition was measured.

The health service, particularly the CQC, uses the information as a way to monitor how safe patients are at each trust.

The rates do not contribute to how a hospital is rated in performance data. The CQC can employ the figures as a way of cross-checking a hospital's assertions about its performance. 

A CQC spokeswoman said: "We do not use mortality rates to assess quality of care directly, but we do use them to direct where we need to dig deeper, for example by conducting an inspection or requesting further information."


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