Challenges in Assessing Hospital-Level Stroke Mortality as a Quality Measure

Background and Purpose—Public reporting efforts currently profile hospitals based on overall stroke mortality rates, yet the “mix” of hemorrhagic and ischemic stroke cases may impact this rate.

Methods—Using the 2005 to 2006 New York state data, we examined the degree to which hospital stroke mortality rankings varied regarding ischemic versus hemorrhagic versus total stroke. Observed/expected ratio was calculated using the Agency for Healthcare Research and Quality Inpatient Quality Indicator software. The observed/expected ratio and outlier status based on stroke types across hospitals were examined using Pearson correlation coefficients (r) and weighted κ. Read more