Our stories - Lower risk of mortality in U-M adult medical and surgical intensive care units, compared to national APACHE database
BACKGROUND
Using patient physiologic measures – such as blood pressure, heart rate and laboratory values – ICU and hospital mortality rates can be predicted based on data collected from hospitals across the nation. APACHE III (Acute Physiology, Age, Chronic Health Evaluation), a refined outcome measurement tool used by the Agency for Health Care Policy and Research (and validated in numerous studies during the past two decades), provides a Standardized Mortality Ratio or SMR for adult ICU patients and hospitals across the nation.
To determine an individual hospital's SMR, the actual, or observed, rate of mortality is divided by the predicted, or expected, rate forecasted by previous patients with similar conditions. Higher rates of mortality than expected will produce an SMR greater than 1. A ratio of 1 indicates mortality rates at levels expected; numbers less than 1 indicate that mortality rates are better than expected.
DATA
The University of Michigan Health System adult Surgical Intensive Care Unit and Critical Care Medicine Unit have SMRs that are significantly less than 1, which means that U-M's ICU mortality rates are much better than expected for the kinds of patients treated in these ICUs.
Reporting period: January 1, 2006 to December 31, 2006
U-M Surgical ICU (20 beds) |
|
Observed Mortality Rate |
4.38 percent |
Predicted Mortality Rate |
÷ 6.42 percent |
Standardized Mortality Ratio or SMR |
= 0.68 or 32 percent better than expected |
U-M CCMU (20 beds) |
|
Observed Mortality Rate |
18.24 percent |
Predicted Mortality Rate |
÷ 21.04 percent |
Standardized Mortality Ratio or SMR |
= 0.87 or 13 percent better than expected
|
WHAT THIS MEANS FOR PATIENTS
Standardized mortality ratios less than 1 indicate mortality rates at the U-M are better than expected according to rigorous national standards and risk adjustment. Mortality rates for U-M Surgical ICU patients are 32 percent better than expected, and mortality rates for U-M Critical Care Medicine Unit patients are 13 percent better than expected.
FOR MORE INFORMATION
To find out more about U-M performance and APACHE III measurements, contact Vinita Bahl, M.D.M., director, Clinical Information and Decision Support Services, at 734-615-0294.
To learn more about how the University of Michigan is committed to quality and appropriateness, contact John E. Billi, M.D., associate dean for Clinical Affairs, University of Michigan Medical School, at 734-936-5214, or Darrell Campbell Jr., M.D., chief of staff, University of Michigan Hospitals and Health Centers, at 734-936-5814.
For more detailed information on the medical terms used in this article, go to the University of Michigan's Health Topics A to Z
