Inpatient Mortality Indicators

The Inpatient Mortality Indicators (IMIs) are part of the Inpatient Quality Indicators that were developed by the federal Agency for Healthcare Research and Quality (AHRQ).  These measures provide a perspective on hospital quality of care with a focus on inpatient mortality for certain procedures and medical conditions, where evidence suggests that high mortality rates may be associated with deficiencies in the quality of hospital care provided.  

Which IMIs are Included in this Analysis?

The 2019 IMIs consist of six medical conditions and five surgical procedures.

Medical Conditions:

  • Acute Myocardial Infarction
  • Acute Stroke (Total, Hemorrhagic, Ischemic, and Subarachnoid)
  • Gastrointestinal Hemorrhage
  • Heart Failure
  • Hip Fracture
  • Pneumonia

Surgical Procedures:

  • Abdominal Aortic Aneurysm Repair – Open and Unruptured
  • Abdominal Aortic Aneurysm Repair – Endovascular and Unruptured
  • Carotid Endarterectomy
  • Pancreatic Resection
  • Percutaneous Coronary Intervention

Why are the IMIs Important?

The IMIs were calculated for the patients who died in the hospital before discharge.  The rates vary substantially across hospitals, suggesting differential quality of care provided by hospitals.  The IMI findings provide performance benchmarks that hospitals can utilize to improve quality and patients can use to make informed healthcare decisions.

Which Hospitals have Better than Expected and Worse than Expected Mortality Rates?

Hospitals were rated “Better”, “Worse”, or “As Expected” by comparing their risk-adjusted mortality rates with the overall state rates for each IMI.  Risk adjustment is a statistical methodology that takes into account a patient’s age, sex, and underlying health conditions.  Hospitals with a higher mortality rate are distinguished from those with a lower mortality rate, indicating opportunities for care quality improvement.

Note: Based on the AHRQ methodology, hospitals were not reported for a specific medical condition or procedure if fewer than three patients were treated.  

Where are Hospitals with Better than Expected and Worse than Expected Mortality Indicators Located?

The map displays geographic locations of hospitals with “Better”, “Worse” and “As Expected” performance ratings on each of the 11 IMIs. 

Note: Based on the AHRQ methodology, hospitals were not reported for a specific medical condition or procedure if fewer than three patients were treated.

How Have Individual Hospitals’ Inpatient Mortality Indicators Changed Over Time?

This visualization shows differences in hospitals’ IMI ratings from year to year for 2016 to 2019, which can be used to assess changes in hospital performance and quality of care over time.  Note that changes have been made to the AHRQ software and IMI specifications over the last ten years. As a result, trend comparisons may not be appropriate for IMIs.  

Note: Based on the AHRQ methodology, hospitals were not reported for a specific medical condition or procedure if fewer than three patients were treated.

Additional Information

Topic: Healthcare Quality
Temporal Coverage: 2016-2019
Spatial/Geographic Coverage: Statewide
Frequency: Annual
Source Link: AHRQ Quality Indicators
Citation: Office of Statewide Health Planning and Development: Healthcare Quality