Printed in Grat Britain PII: S1353-4505(97)00007-0 i3J3-45O5/97$n.oo+o.oo The Relationship Between Choice of Outcome Measure and Hospital Rank in General Surgical Procedures: Implications for Quality Assessment

Objectiir. Institutional complication rates are often used to assess hospital quality of care, particularly for conditions and procedures where mortality rates are not useful because deaths are rare. The objective of this study was to assess the correlation among hospital quality assessment rankings based on adjusted mortality, complication and faiiure-to-rescoe rates. Design: This study used a clinically detailed administrative data set to compare severity and case-mix adjusted hospital outcome rankings for three different measures of quality of care: in-hospital death, complication and failure-to-rescue (In-bospital death following a complication). Setting and Patients: Analysis of 74 647 patients who under-went general surgical procedures included in the 1991 and 1992 MedisGroups National Comparative Data Base. Measurement?. Adjusted outcomes of death, complication an