Current measures of hospital mortality, especially when derived from administrative data, are limited as a performance measure. Researchers from the Ottawa Health Research Institute and Sunnybrook Health Sciences Centre in Toronto suggest other ways to measure performance in this analysis of the hospital standardized mortality ratio. More comprehensive measures based on detailed clinical data and other measures are necessary, although this will require additional resources.

"Developing satisfactory performance measures will require substantial investment," state the researchers. "Mortality measures will need to focus on specific conditions and procedures with known connections to elements of care that providers are able to control….Although expensive, the process of obtaining detailed clinical data would support accurate risk adjustment for mortality outcomes."