Chapter 6 Mortality Rates

Mortality Rates Guidelines

- Mortality rates are typically expressed as a percentage rounded to the nearest tenth of a percent or one decimal point - Death is a type of DC - If deaths of NB inpatients are included in the numerator, all DCs of NB inpatients must be included in the denominator - Patients who are dead on arrival (DOA) are not included - Patients who die in the hospital while outpatients or in the ED are not included in the gross mortality rates since they were not admitted as an inpatient

postpartum

after childbirth

The postoperative mortality rate is limited to patients

that die within 10 days of the procedure bc other conditions beyond the surgical procedure itself may be the cause of death.

Maternal death

the death of a woman while pregnant, during delivery, or within 42 days of termination delivery from any cause related to or aggravated by pregnancy or its management (regardless of duration or site of pregnancy)

Gross mortality rate (hospital mortality rate)

the number of inpatient deaths for a period of time divided by the total number of live DCs and deaths for the same time period

prepartum, antepartum

time period before birth

Newborn

An inpatient who was born in a hospital at the beginning of the current inpatient hospitalization

surgical procedure

Any single, separate, systematic process upon or within the body that can be complete in itself; is normally performed by a physician, dentist, or other licensed practitioner; can be performed either with or without instruments; and is performed to restore disunited or deficient parts, remove diseased or injured tissues, extract foreign matter, assist in obstetrical delivery, or aid in diagnosis

OB discharges

DCs of women while pregnant or within 42 days of termination of the pregnancy

early fetal death

Fewer than 20 weeks of gestation and a weight of 50 grams or less

Why Net / Institutional mortality rate was created:

It was felt that healthcare providers should be held accountable for a death that occurred less than 48 hours after admission, as they would not have had enough time to directly affect the patient's conditions

Neonatal death

The death of a live-born infant within the first 28 days, following the moment of birth

Newborn Death

The death of a liveborn infant born in the hospital who later dies during the same admission.

Postneonatal death

The death of a liveborn infant from 28 days to the end of the first year of life (364 days, 23 hours, and 59 minutes from the moment of birth)

intermediate fetal death

The death of a product of human conception before its complete expulsion or extraction from the mother that is 20 complete weeks of gestation (but less than 28 weeks) and weighs 501 to 1,000 grams

late fetal death

The death of a product of human conception that is 28 weeks or more of gestation and weighs 1,001 grams or more before its complete expulsion or extraction from the mother

Maternal Mortality Rate

The number of women who die giving birth per 100,000 births. (page 95)

Cancer mortality rate

The proportion of patients who die from cancer

hospital live birth

a live birth that occurs in a hospital

Mortality rate (death rate)

a rate that measures the risk of death for a defined population (location, cause of death, age, etc)

mortality

a term referring to the incidence of death in a specific population

cancer registrar

an individual who is responsible for maintaining a cancer registry

Surgical operations

as one or more surgical procedures performed at one time for one patient via a common approach or for a common purpose

cancer registry

collection of information about the occurrence of cancer, the types of cancers that occur and their locations within the body, the extent of cancer at the time of diagnosis (disease stage), and the kinds of treatment that patients receive.

Perinatal death

death that occurs from 22 weeks of completed gestation to 7 completed days from the moment of birth

CMS

is the division of the Dept. of HHS that is responsible for developing healthcare policy in the US and for administering the Medicare program and the federal portion of the Medicaid program. Also, published Hospital Compare at medicare.gov

Net / Institutional mortality rate

is the number inpatients that died more than 48 hours after admission divided by the number of DC including deaths Newborns are included in the inpatient deaths along with the adult and children deaths

case fatality rate

percentage of population that dies from a specific disease total number of deaths due to a specific illness during a given time period divided b the total number of cases during the same period

Postoperative / Surgical Mortality Rate

refers to the number of deaths occurring after an operation has been performed. The criteria for computing the postoperative mortality rate includes the ratio deaths within 10 days after surgery to the total number of patients operated on during that period.

complications

secondary or additional problems; a medical condition that arises during a hospitalization.