Risk-standardized mortality metric to monitor hospital performance for chest pain presentations
Authors' conclusion
Annual hospital 30-day RSMR can be feasibly calculated at the symptom-level using routinely collected, linked clinical, and administrative data. This outcome-based metric appears to provide additional information for monitoring hospital performance in comparison with existing process of care key performance measures.
Study context
- Population
- Adults with acute chest pain without ST-elevation brought by emergency medical services (EMS) to 53 EDs in Victoria, Australia (1/1/2015–30/6/2019)
- Participants
- 192,978 adults53 EDs
- Outcome
- Feasibility of symptom-level risk-standardized mortality rate (RSMR) to monitor hospital performance
- Follow-up
- mean 30-day
Methodological detailsmulticentre, linked clinical and administrative data, bootstrap internal validation, Model developed from 32 candidate variables, risk-standardized mortality rates (RSMR) = observed/expected mortality × annual mean 30-day mortality rate
- Multicentre
- Linked clinical and administrative data
- Bootstrap internal validation
- Model developed from 32 candidate variables
- RSMR = observed/expected mortality × annual mean 30-day mortality rate
Main finding
As reported in the abstract
30 days
Risk-adjusted logistic regression model for 30-day mortality, C-statistic
0.899
Observational data: associations, not effects.
Original publication
Risk-standardized mortality metric to monitor hospital performance for chest pain presentations. Eur Heart J Qual Care Clin Outcomes. Published 4 October 2022. doi:10.
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