Inpatient Mortality Indicators
When compared to the statewide rates, 59 hospitals (18.7 percent) were rated “Better,” and 73 hospitals (23.2 percent) were rated “Worse” on at least one risk-adjusted mortality indicator.
The Inpatient Mortality Indicators (IMIs), developed by the Agency for Healthcare Research and Quality (AHRQ), were calculated for the patients who died in the hospital before discharge. The rates vary substantially across hospitals, suggesting differential quality of care provided by hospitals. The IMI findings provide performance benchmarks that hospitals can utilize to improve quality and patients can use to make informed healthcare decisions. The current report includes six medical conditions (Acute Myocardial Infarction, Acute Stroke, Gastrointestinal Hemorrhage, Heart Failure, Hip Fracture, and Pneumonia) and three surgical procedures (Carotid Endarterectomy, Pancreatic Resection, and Percutaneous Coronary Intervention) for which risk-adjusted mortality rates were reported.
Hospitals were rated “Better,” “Worse,” or “As Expected” by comparing their risk-adjusted mortality rates with the overall statewide rates for each IMI. Risk adjustment is a statistical methodology that takes into account a patient’s age, sex, and underlying health conditions. Hospitals with a higher mortality rate are distinguished from those with a lower mortality rate, indicating opportunities for care quality improvement.
Key Findings
- When compared to the state average rates, 59 hospitals (18.7 percent) were rated “Better”, and 73 hospitals (23.2 percent) were rated “Worse” on at least one risk-adjusted mortality indicator.
- Of the 59 better-rated hospitals, 36 were rated “Better” on a single indicator, 15 on two indicators, 4 on three indicators, 3 on four indicators, and 1 on five indicators.
- Of the 73 worse-rated hospitals, 42 were rated “Worse” on a single indicator, 21 on two indicators, 5 on three indicators, 4 on four indicators, and 1 on four indicators.
- There were 186 (59.0 percent) hospitals rated as “As Expected,” or not significantly different from the state average, for all nine mortality indicators.
- In general, hospitals showed fairly consistent performance across all nine indicators. Three hospitals (1.0 percent), however, had “mixed” results – they were rated “Better” on at least one indicator and “Worse” on at least one indicator.
Note: Due to methodological changes by AHRQ, the following five measures were discontinued for the 2023 report: Abdominal Aortic Aneurysm Repair (Open and Unruptured), Abdominal Aortic Aneurysm Repair (Endovascular and Unruptured), Acute Stroke (Hemorrhagic), Acute Stroke (Ischemic), and Acute Stroke (Subarachnoid). The map visualization displays geographic locations of hospitals with “Better”, “Worse” and “As Expected” performance ratings on each of the nine IMIs.
*Mixed Rating indicates hospitals that were rated “Better” on at least one indicator and “Worse” on at least one indicator.
Additional Information
Topic: Healthcare Quality
Source Link: AHRQ Quality Indicators
Citation: HCAI – California Hospital Inpatient Mortality Rates and Quality Ratings, 2019-2023
Temporal Coverage: 2019-2023
Spatial/Geographic Coverage: Statewide, County
Frequency: Annually