How do time trends in inhospital mortality compare? A retrospective study of England and Scotland over 17 years using administrative data

BMJ Open
María José Aragón, Martin Chalkley

Abstract

To examine the trends in inhospital mortality for England and Scotland over a 17-year period to determine whether and if so to what extent the time trends differ after controlling for differences in the patients treated. Analysis of retrospective administrative hospital data using descriptive aggregate statistics of trends in inhospital mortality and estimates of a logistic regression model of individual patient-level inhospital mortality accounting for patient characteristics, case-mix, and country-specific and year-specific intercepts. Secondary care across all hospitals in England and Scotland from 1997 to 2013. Over 190 million inpatient admissions, either electively or emergency, in England or Scotland from 1997 to 2013. Hospital Episode Statistics for England and the Scottish Morbidity Record 01 for Scotland. Separately for two admission pathways (elective and emergency), we examine aggregate time trends of the proportion of patients who die in hospital and a binary variable indicating whether an individual patient died in hospital or survived, and how that indicator is influenced by the patient's characteristics, the year and the country (England or Scotland) in which they were admitted. Inhospital mortality has declined...Continue Reading

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Citations

May 29, 2019·Alimentary Pharmacology & Therapeutics·Mustafa ShawihdiKeith Bodger

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