May 23, 1986

The Evaluation of Hospital Death Rates

Author Affiliations

Stanford University School of Medicine Stanford, Calif

JAMA. 1986;255(20):2801. doi:10.1001/jama.1986.03370200103039

The article by Luft and Hunt1 in this issue of The Journal has acquired an urgent relevancy since it was accepted for publication. In that time interval, the Department of Health and Human Services has begun to release individually identified hospital death rates.

Luft and Hunt examined the 1982 experience of patients undergoing cardiac catheterization in the 151 member hospitals of the Commission on Professional and Hospital Activities known to have had cardiac catheterization laboratories in that year. Confidentiality mechanisms ensured that the authors were blind to the identity of the hospitals from which the data came.

The age of the patient and the patient's disease are both powerful influences on the probability of death, so the investigators sorted the patients into 12 categories, defined as the possible combinations of three age groups and four diagnostic groups. For each of these 12 categories, the whole-study death rate (across the