ESRI Seminar: "Do Variations in Emergency Admission Rates Explain Variations in Hospital Mortality?"

Guest Speaker: Matt Sutton, Manchester Centre for Health Economics, University of Manchester

Standardised hospital mortality rates are widely used as a measure of hospital quality. There are a wide range of criticisms of their use. In this presentation, I will focus on hospitals’ influence on the denominator i.e. the volume and composition of admissions. I will summarise previous work, in which we showed that variation in the probability of admission accounted for the elevation of mortality amongst weekend admissions. I will then describe ongoing work in which we examine whether variations in hospitals’ propensities to admit patients attending emergency departments are associated with standardised mortality rates amongst the admitted population. Using data on all emergency department attendances and all hospital admissions to 130 hospitals across England, we show that variations in admission rates are a significant explanation for variations in hospital mortality rates.