Healthcare Information Division

AHRQ - Inpatient Quality Indicators (IQIs)

Hospital Inpatient Mortality Indicators for California, 2008 and 2009

Executive Summary

Overview
Evidence suggests that high mortality may be associated with deficiencies in the quality of hospital care provided.  The Inpatient Mortality Indicators (IMIs) are part of a suite of measures called Inpatient Quality Indicators (IQIs), developed by the Federal Agency for Healthcare Research and Quality (AHRQ), that provide a perspective on hospital quality of care, calculated using patient data reported to OSHPD by all California-licensed hospitals. 

Why Report IMIs?
The OSHPD reports IMIs for California hospitals to improve the quality of patient care in the State through greater transparency, to help consumers make more informed healthcare decisions, to help payers and employers spend their healthcare dollars more wisely, and to provide hospitals performance benchmarks, that aid in their review of internal processes of care and quality improvement activities.

How OSHPD Calculated IMIs?
Data to calculate IMIs come from all California-licensed hospitals.  All IMIs include risk-adjustment, a process that takes into account patients' pre-existing health problems to "level the playing field" and allow fair comparisons among hospitals. Additional information about the IMI calculation methods, and technical details about their validity and limitations can be found on the AHRQ website, and in the OSHPD Technical Note.

2008 and 2009 IMI Results

The links below contain the IMI ratings of all California-licensed hospitals:

2009 Inpatient Mortality Indicators pdf , xls
2008 Inpatient Mortality Indicators pdf , xls
Technical Note
2007 and 2006 Inpatient Mortality Indicators

The 2008 and 2009 IMI reports include the 12 indicators shown below.

California 2008 and 2009 Inpatient Mortality Indicator (IMI) Statewide Mortality Rates
(Per 100 Cases)

(* measures not included in 2006 or 2007 OSHPD IMI reports)

Medical Condition

2008

2009

Acute Stroke [including hemorrhagic]
10.6
10.4
Acute Myocardial Infarction* [heart attack including transfers between healthcare facilities]
7.5
7.1
Congestive Heart Failure* [heart failure]
3.4
3.3
Gastrointestinal Hemorrhage [intestinal bleeding]
2.4
2.3
Hip Fracture
2.7
2.4
Pneumonia*
4.8
4.6
     

Procedure

2008 

2009

Abdominal Aortic Artery Repair* [for ruptured or bulging aorta]
2.1
1.9
Carotid Endarterectomy [surgery on the carotid artery in neck]
0.6
0.7
Craniotomy [operation through the skull, including brain surgery]
7.5
6.7
Esophageal Resection [removal of all or part of the esophagus]
5.4
5.8
Pancreatic Resection [removal of all or part of the pancreas]
5.0
5.2
Percutaneous Transluminal Coronary Angioplasty (PTCA) [non-surgical coronary artery disease treatment, may include insertion of a stent]
1.8
1.9

Among hospitals in 2008 and 2009:

  • Individual hospitals showed relatively consistent performance across the 12 IMIs.
  • Many hospitals showed consistent performance across the two years. Hospitals that scored “Worse” on at least one indicator in 2008 were five times more likely than other hospitals to score “Worse” on at least one indicator in 2009.  Similarly, “Better” hospitals in 2008 were six times more likely to have performed “Better” in 2009.
  • More hospitals were rated better in 2009 than in 2008, and fewer were rated worse in 2009 than in 2008.

In 2009, among 335 hospitals in the report:

  • 119 hospitals were rated “Better” and 64 were rated “Worse” than the state average on at least one indicator. 160 hospitals were rated as “Average,” or not significantly different from the state average, on all 12 indicators.
  • Among hospitals with “Worse” ratings, 50 were rated “Worse” on a single indicator, 11 on two indicators, and 3 on three indicators. 
  • Of the hospitals with “Better” ratings, 61 were rated “Better” on a single indicator, 35 on two indicators, 17 on three indicators, 5 on four indicators, and one hospital was rated “Better” on 6 of the 12 indicators.

    Return to OSHPD AHRQ overview page.

 

Page last revised: November 6, 2012 9:00 AM