[Relationship between in-hospital and peri-hospital mortality: Analysis of quality reports covering insured from local sickness funds].

Dtsch Med Wochenschr 135(41):2015-20 (2010) PMID 20925008

In-hospital mortality is a common criterion for evaluating the quality of medical care provided for inpatients. Besides general concerns, the call for a defined follow-up-period is the subject to be discussed. A project - abbreviated as QSR - covering insured from local health insurance funds now provides respective information. By this means, the relationship between in-hospital and peri-hospital mortality can be elaborated. Data regarding in-hospital mortality, mortality 30 days, 90 days as well as one year after admission was gathered from QSR quality reports covering 31 hospitals of the HELIOS hospital group. The relationship between the various periods was determined by the non-parametric correlation coefficient, whereas trends were analyzed based on linear regression. There is a relevant (r between 0.552 and 0.908) and significant (p ≤ 0.006) relation between the various periods with respect to heart failure, cardiac infarction, and stroke or intracerebral haemorrhage. As to surgical fields, comparable results can be recognized. Fifteen out of 85 courses show a statistically significant trend. Only four courses are tangent to the threshold 1 applicable for the standard mortality ratio. The study revealed no imperative need to analyze mortality for longer follow-up-periods in order to assess quality of inpatient health care. Therefore, future efforts should concentrate on the identification of an adequate operand that supports best the hospitals in their internal quality management. © Georg Thieme Verlag KG Stuttgart · New York.