Hospital inspections may be better guide to performance than star ratings


Dr Foster's case notes CHI ratings and HSMRs: is there a relation? BMJ Volume 329, p 73

Hospital inspection scores may be a better measure of performance than star ratings, according to an analysis by Dr Foster in this week's BMJ.

From 2001-3, the performance of NHS trusts has been monitored through a star rating system established by the Department of Health (DoH). The Commission for Health Improvement (CHI - now part of the Healthcare Commission) has conducted on-site inspections that give hospitals scores for a variety of issues related to quality of care.

Researchers analysed whether there was a relation between both CHI star ratings and CHI inspection scores and hospital death rates, known as hospital standardised mortality ratios (HSMRs).

They found no significant relation between HSMRs and DoH star ratings: an increase in one star was associated with a 0.4% fall in HMSR. However, they did find a significant relationship with CHI inspection scores: each point increase in the CHI inspection score was associated with a 1.35% decrease in HMSR.

These findings suggest that inspection scores may provide the public with a better guide to an important measure of hospital outcomes than star ratings, conclude the authors.

Source: Eurekalert & others

Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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