Predicting acute myocardial infarction (AMI) 30-days mortality: Using standardised mortality ratio (SMR) as the hospital performance measure

Kamarulariffin Kamarudin M; Tan Jen Ai C; Lisa Zaharan N; Yahya A

doi:10.1016/j.ijmedinf.2022.104865

Predicting acute myocardial infarction (AMI) 30-days mortality: Using standardised mortality ratio (SMR) as the hospital performance measure

Kamarulariffin Kamarudin M ¹ , Tan Jen Ai C ² , Lisa Zaharan N ³ , Yahya A ¹

Affiliations

¹ Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
² Health Performance Unit, Office of NIH Manager, National Institute of Health, Ministry of Health Malaysia, Malaysia
³ Department of Pharmacology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia

Int J Med Inform, 2022 Dec;168:104865.

PMID: 36334465 DOI: 10.1016/j.ijmedinf.2022.104865

Abstract

BACKGROUND: A standardised mortality ratio (SMR) is the hospital observed mortality divided by its predicted mortality and has been used as an indicator to monitor hospital performance.

OBJECTIVES: This study developed a model that predicted 30-day mortality for acute myocardial infarction (AMI) and compared the SMR among 41 Malaysian public hospitals using statistical process control charts.

METHODS & RESULTS: Data from referral centres and specialist hospitals with cardiology services were analysed. Both referral centres and specialist hospitals had comparable mortality, except for Hospitals A and B, which the study considered outliers. Two-thirds of the remaining hospitals had an SMR of above one (SMR 1.05-1.51), but the indices were still within the expected variations.

CONCLUSION: The SMR coupled with a funnel plot and variable life adjusted display (VLAD) can identify hospitals with potentially higher than expected mortality rates.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.