Relationship between preventable hospital deaths and other measures of safety: an exploratory study.


Hogan, H; Healey, F; Neale, G; Thomson, R; Vincent, C; Black, N; (2014) Relationship between preventable hospital deaths and other measures of safety: an exploratory study. International journal for quality in health care, 26 (3). pp. 298-307. ISSN 1353-4505 DOI: https://doi.org/10.1093/intqhc/mzu049

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Abstract

OBJECTIVE: To explore associations between the proportion of hospital deaths that are preventable and other measures of safety.<br/> DESIGN: Retrospective case record review to provide estimates of preventable death proportions. Simple monotonic correlations using Spearman's rank correlation coefficient to establish the relationship with eight other measures of patient safety.<br/> SETTING: Ten English acute hospital trusts.<br/> PARTICIPANTS: One thousand patients who died during 2009.<br/> RESULTS: The proportion of preventable deaths varied between hospitals (3-8%) but was not statistically significant (P = 0.94). Only one of the eight measures of safety (Methicillin-resistant Staphylococcus aureus bacteraemia rate) was clinically and statistically significantly associated with preventable death proportion (r = 0.73; P < 0.02). There were no significant associations with the other measures including hospital standardized mortality ratios (r = -0.01). There was a suggestion that preventable deaths may be more strongly associated with some other measures of outcome than with process or with structure measures.<br/> CONCLUSIONS: The exploratory nature of this study inevitably limited its power to provide definitive results. The observed relationships between safety measures suggest that a larger more powerful study is needed to establish the inter-relationship of different measures of safety (structure, process and outcome), in particular the widely used standardized mortality ratios.<br/>

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Health Services Research and Policy
Faculty of Public Health and Policy > Dept of Global Health and Development
PubMed ID: 24781497
Web of Science ID: 337040000010
URI: http://researchonline.lshtm.ac.uk/id/eprint/1683809

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