How Can We Use Hospital-Standardized Mortality Ratio as a Quality Indicator of Hospital Care in Korea?.
10.4332/KJHPA.2017.27.2.114
- Author:
Seon Ha KIM
1
;
Eun Young CHOI
;
Hyeon Jeong LEE
;
Minsu OCK
;
Min Woo JO
;
Sang il LEE
Author Information
1. Department of Nursing, Dankook University College of Nursing, Cheonan, Korea.
- Publication Type:Review
- Keywords:
Hospital standardized mortality ratio;
Generic quality indicator;
Quality of health care
- MeSH:
Clinical Coding;
Korea*;
Mortality*;
Quality of Health Care;
Risk Adjustment
- From:Health Policy and Management
2017;27(2):114-120
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The hospital standardized mortality ratio (HSMR) is a widely used generic measure for assessing quality of hospital care in many countries. However, the validity of HSMR as a quality indicator is still controversial. We critically reviewed characteristics of HSMR and suggested how to use HSMR as a quality indicator in the Korean setting. The association between HSMR and other quality measures of hospital care is inconclusive. In addition current HSMR model has shortcomings in risk adjustment because of the lack of clinical data, accuracy of disease coding, coding variation among hospitals, end-of-life care issues, and so on. Therefore, HSMR should be used as an indicator for improvement, not for judgement such as public reporting and pay-for-performance. More efforts will be needed to tackle practical and methodological weaknesses of HSMR in the Korean setting.
