August 15, 2007

Mortality as a Measure of QualityImplications for Palliative and End-of-Life Care

Author Affiliations

Author Affiliations: Department of Neurology (Dr Holloway), Department of Medicine (Dr Quill), and Center for Ethics, Humanities, and Palliative Care (Drs Holloway and Quill), University of Rochester Medical Center, Rochester, New York.

JAMA. 2007;298(7):802-804. doi:10.1001/jama.298.7.802

Mortality as a measure of quality has made a comeback. In 1986, the Health Care Financing Administration (now the Centers for Medicare & Medicaid Services [CMS]) released hospital-specific mortality rates to the public, but abandoned those efforts in 1993 given concerns about the validity of the comparisons. In 2002, the Agency for Healthcare Research and Quality released 15 administratively driven inpatient mortality indicators. Twenty-nine report cards now contain information about hospital mortality.1 In addition, the Institute of Medicine in 2006 endorsed the inclusion of disease-specific mortality as 1 of the 2 outcome measures for consideration in developing a national system for performance measurement.2

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