Healthcare Information Division

AHRQ - Inpatient Quality Indicators (IQIs)

Hospital Inpatient Mortality Indicators for California, 2010 and 2011

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. For this release OSHPD is using a new version of the AHRQ software that incorporates changes made by AHRQ and OSHPD. Importantly, OSHPD no longer incorporates national data in benchmarking California hospital performance - all hospital comparisons are with California data only. This has resulted in a more balanced number of "Better" and "Worse"-performing hospitals this year. It has also made comparisons of hospital performance with prior years not possible. 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.

2010 and 2011 IMI Results

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

2011 Inpatient Mortality Indicators pdf , xls
2010 Inpatient Mortality Indicators pdf , xls
Technical Note
2009 and 2008 Inpatient Mortality Indicators
2007 and 2006 Inpatient Mortality Indicators

The 2010 and 2011 IMI reports include the 12 indicators shown below.

California 2010 and 2011 Inpatient Mortality Indicator (IMI) Statewide Mortality Rates
(Per 100 Cases)

Medical Condition

2010

2011

Acute Stroke [including hemorrhagic]
10
9.4
Acute Myocardial Infarction [heart attack including transfers between healthcare facilities]
6.8
6.5
Heart Failure
3
3
Gastrointestinal Hemorrhage [intestinal bleeding]
2.2
2.2
Hip Fracture
2.5
2.3
Pneumonia
4.1
4.1
     

Procedure

2010 

2011

Abdominal Aortic Aneurism Repair [for bulging abdominal aorta]
1.4
1.9
Carotid Endarterectomy [surgery on the carotid artery in neck]
0.5
0.5
Craniotomy [operation through the skull, including brain surgery]
6.6
6.8
Esophageal Resection [removal of all or part of the esophagus]
3.9
3.8
Pancreatic Resection [removal of all or part of the pancreas]
4.5
3.1
Percutaneous Coronary Intervention (PCI) [non-surgical coronary artery disease treatment, including insertion of a stent]
2
2.3

Among hospitals in 2010 and 2011:

  • 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 2010 were 5.7 times more likely than other hospitals to score “Worse” on at least one indicator in 2011.  Similarly, “Better” hospitals in 2010 were 6.5 times more likely to have performed “Better” in 2011.

In 2011, among 331 hospitals in the report:

  • 65 hospitals were rated “Better” and 95 were rated “Worse” than the state average on at least one indicator. 183 hospitals were rated as “Average,” or not significantly different from the state average, on all 12 indicators.
  • Among hospitals with “Worse” ratings, 70 were rated “Worse” on a single indicator, 19 on two indicators, 5 on three indicators, and 1 on five indicators. 
  • Of the hospitals with “Better” ratings, 46 were rated “Better” on a single indicator, 15 on two indicators, and 4 hospitals were rated “Better” on three of the 12 indicators.

In 2010, among 331 hospitals in the report:

  • 56 hospitals were rated "Better" and 82 were rated "Worse" than the state average on at least one indicator. 194 hospitals were rated as "Average," or not significantly different from the state average, on all 12 indicators.
  • Among hospitals with "Worse" ratings, 55 were rated "Worse" on a single indicator, 16 on two indicators, 7 on three indicators, 3 on four indicators, and 1 on five indicators.
  • Of the hospitals with "Better" ratings, 34 were rated "Better" on a single indicator, 14 on two indicators, 7 on three indicators, and 1 hospital was rated "Better" on four of the 12 indicators.

Return to OSHPD AHRQ overview page.

 

Page last revised: April 17, 2013 4:14 PM