About this release
This release by Public Health Scotland (PHS) provides information on Hospital Standardised Mortality Ratios (HSMRs) for the period January 2016 to December 2020. These statistics are updated on a quarterly basis and reflect the HSMR for the latest 12-month reporting period when drawing comparisons against the Scottish average, whilst crude mortality data is presented by quarter and month to show trends.
- For the period January 2020 to December 2020 no hospital had a significantly higher standardised mortality ratio than the national average.
- For the period January 2020 to December 2020 one hospital had a significantly lower standardised mortality ratio than the national average: Western General Hospital, Edinburgh (0.78).
Hospital mortality measures have an important role to play in stimulating reflection on the quality and safety of patient care. PHS has produced quarterly HSMRs for hospitals since December 2009.
The HSMR is based on all acute inpatient and day case patients admitted to all specialties in hospital (apart from obstetrics and psychiatry which are excluded). The calculation takes account of patients who died within 30 days from admission and includes deaths that occurred in the community as well as those occurring in hospitals.
The Scottish HSMR is 1.00. If a HSMR value for a hospital is less than one, this means the number of deaths within 30 days of admission for this hospital is fewer than predicted. If a HSMR value for a hospital is greater than one, this means the number of deaths within 30 days for this hospital is more than predicted.
If the number of deaths is more than predicted this does not necessarily mean that these were avoidable deaths (i.e. that they should not have happened), or that they were unexpected, or attributable to failings in the quality of care.
The methodology has been updated to ensure the diagnosis ICD-10 codes for COVID19, U07.1 and U07.2, are included in the model. For more information please refer to the HSMR COVID-19 Methodology Update paper (external website).
During the pandemic, hospitals have had to adjust their normal ways of working to react to this healthcare emergency. As a result, there will be changes in the volumes of activity in some of the groups used to calculate the HSMRs, for example, fewer elective admissions. Any changes in crude mortality trends and HSMRs should be considered in this context.
A Technical Document (external website) is available on how HSMR is calculated. A Frequently Asked Questions (external website) document is also available. For more information on HSMR see HSMR section of our website (external website). HSMRs published from August 2019 onwards cannot be compared to prior releases using a different methodology. For more information see Research and Development (external website).
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