A proposal for quality assessment through mortality data]

Objective. To introduce the Hospital Standardized Mortality Ratio (HSMR) as an alternative to assess the quality of hospital care in Mexico. Material and Methods. Datasets of public hospital discharges were used as source of information. The analyses were based in a logistic model to estimate the risk of hospital death adjusting by sex, age, length of stay and main diagnosis. The HSMR is estimated dividing the observed deaths by the addition of the risk for each discharge by hospital. Results. The ISSSTE had the lowest HSMR. At state level, the best figure was obtained by the hospitals of the ISSSTE in Veracruz, while the worst performance corresponds to hospitals of the SS in Nayarit. Conclusion. Our results suggest that this indicator can be used as a suitable alternative to evaluate the performance of hospitals in terms of mortality.