Mortality Measurement Presentations from a November 2008 meeting to discuss issues related to mortality measures. There is increasing interest in deploying and publicly reporting a risk-adjusted measure of mortality as a quality indicator of hospital system-level performance. Government agencies, policymakers, health care systems, and consumers are grappling with critical issues regarding the attributes, relative merits, interpretation, and potential uses of existing measurement methods to drive improvement and inform choice. The presentations provided here are from a November 2008 meeting to discuss issues related to mortality measures.Slide presentations can be accessed using a Free PowerPoint® Viewer.Hospital Standardized Mortality MeasurementThe Agency for Healthcare Research and Quality (AHRQ) and the Institute for Healthcare Improvement (IHI) have partnered to explore the scientific controversies around using a mortality measurement methodology to improve health care quality. The mortality measures would also be used to help track and reduce mortality nationally and in individual institutions.In November 2008, AHRQ and IHI convened a meeting in Cambridge, Massachusetts, to discuss these important issues. Presentations and discussion took place on five existing risk-adjusted mortality measures. In addition, experts reviewed issues related to:The lessons learned from past government efforts to publicly report mortality rates.The National Quality Forum's (NQF) intent to vet a national mortality measure or measures.The pros and cons of including deaths occurring within 30 days of hospital discharge.The progress in measuring diagnosis-specific mortality rates.In addition, ongoing research to include automated clinical data in risk-adjustment methods was presented, and research needs were outlined. Invited attendees included independent measurement experts and stakeholders from major organizations, including the Centers for Medicare & Medicaid Services, Joint Commission, National Quality Forum, National Association of Public Hospitals, American Hospital Association, and Consumer's Union.Selected materials submitted by speakers are presented here. When a speaker has prepared articles for submission to peer-reviewed journals, related and already published articles or other resources are also posted. In addition, a paper summarizing key outputs of this meeting is being prepared. Meeting MaterialsFinal Agenda (PDF File, 135 KB)Meeting Participants (PDF File, 290 KB)Background and Historical Perspective on Mortality MeasurementSpeakers: Steve Jencks and Amy RosenHigh Mortality Rates: Finding the Pony (PDF File, 96 KB)The Need for a National Mortality Measure: NQF's Rationale and RequirementsSpeaker: Janet CorriganNational Priorities Partnership (PDF File, 260 KB)About the National Priorities PartnershipNational Priorities & Goals to Transform America's Healthcare Meeting MaterialsPresentation and Discussion of Individual Mortality MeasuresCareScience/PremierContact: Eugene A. Kroch, Ph.D. (Eugene_Kroch@PremierInc.com)CareScience Mortality Risk Model (PDF File, 915 KB)CareScience Risk Assessment Model: Hospital Performance Measurement (PDF File, 405 KB)Dr. Foster Unit at Imperial College LondonContact: Professor Sir Brian Jarman, OBE, FRCP, FRCGP (b.jarman@imperial.ac.uk)How NHS [National Health Service] Trusts Could Use Patient Safety Indicators To Help Improve Care Health Care Risk Report 14(6):12-14. Courtesy of the Health Care Risk ReportAylin P, Bottle A, Majeed A. Use of administrative data or clinical databases as predictors of risk of death in hospital: comparison of models.BMJ 2007;334(7602):1044. (published online 23 April 2007). Select for abstract.Bottle A, Aylin P. Mortality associated with delay in operation after hip fracture: observational study.BMJ 2006;332:947-51. Select for abstract.Jarman B, Bottle A, Aylin P, et al. Monitoring changes in hospital standardized mortality ratios.BMJ 2005;330:329. Select for abstract.Aylin P, Bottle B, Jarman B, et al. Paediatric cardiac surgical mortality in England after Bristol: Descriptive analysis of hospital episode statistics 1991-2002.BMJ 2004;329:825. Select for abstract.Jarman B, Gault S, Alves B, et al. Explaining differences in English hospital death rates using routinely collected data.BMJ 1999;318:1515. Select for abstract.University Health ConsortiumContact: Steven J. Meurer, Ph.D., M.B.A., M.H.S (meurer@uhc.edu)Mortality Risk Adjustment Methodology for University Health System's Clinical Data Base (PDF File, 185 KB)3M Health Information Systems (HIS)Contacts:Elizabeth McCullough (ecmccullough@mmm.com; 301-281-8463)John Hughes, M.D. (jshughes@mmm.com; 203-949-6418)Development of the 3M™ All Patient Refined Diagnosis Related Groups (APR DRGs) (PDF File, 488 KB)3M HIS APR™-DRG Classification Software—Overview (PDF File, 82 KB)Thomson ReutersContact: Dave Foster, Ph.D., M.D. (david.a.foster@thomsonreuters.com)Thomson Reuters (PDF File 974 KB) (Powerpoint® File, 712 KB)Challenges and Opportunities of a 30-Day Mortality MeasureSpeakers: Harlan Krumholz and Sharon-Lise NormandPublication of paper pending.Aggregate Versus Diagnosis-Specific Risk-Adjusted MortalitySpeakers: David Shahian and Barry StraubePublication of paper pending.Mortality Measurement in the EMR Era: What Real Time Lab and Clinical Data Can Contribute to Precision and PredictionSpeakers: Gabriel Escobar and Marta RenderMortality Measurement in the EMR Era (PDF File, 94 KB) (Powerpoint® File, 464 KB)The Veterans Health Affairs Experience in Measuring and Reporting Inpatient Mortality (PDF File, 188 KB)Next Steps and Potential Research Studies to Accelerate Adoption of a National Mortality MeasureSpeaker/Facilitators: Evan Benjamin and Eugene NelsonNext Steps and Potential Research Studies to Accelerate Adoption of a National Mortality Measure (PDF File, 3.1 MB) Current as of March 2009 Internet Citation: Mortality Measurement. March 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/mortality/index.html