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  1. 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
    Int J Med Inform, 2022 Dec;168:104865.
    PMID: 36334465 DOI: 10.1016/j.ijmedinf.2022.104865
    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.

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