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Basic Facts about the Mortality Inpatient Quality Indicator (IQI) for Heart Attack, Heart Failure, Pneumonia and Stroke
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What does mortality mean?

“Mortality” is another word for patient death. Mortality is an outcome of care measure. This section of the web site focuses on the mortality rate of NJ hospitals for heart attack, heart failure, pneumonia and stroke patients. The mortality rate is shown as a percentage and is based on the number of patients who were treated but died in a NJ hospital. The IQI mortality measures in this section of the web site include patients 18 years or older and are based on 2007 data.

Using a statistical method called “risk adjusting”, the numbers are adjusted to account for differences in patient characteristics. For example, a patient’s previous health status, like a chronic illness or advanced age, may influence the outcome of the treatment. The purpose of “risk adjusting” the numbers is to standardize the data so that hospitals that treat sicker or older patients can be fairly compared to other hospitals that do not treat so many sick or elderly patients.

What do the measures mean and why are they important?

The mortality measure used in this section of the web site is part of a set of measures called Inpatient Quality Indicators (IQIs). The IQIs were developed at the national level by the Agency for Health Care Research and Quality (AHRQ). AHRQ spent years of research and analysis before defining these measures. The IQIs are national standards of care or best practices.

For mortality, lower rates indicate fewer deaths; unlike Recommended Care/Process of Care Measures, lower scores show a better performance. High mortality rates may indicate deficiencies in the quality of care.

Acute Myocardial Infarction (AMI) Mortality

AN AMI is a heart attack and can occur if the arteries supplying blood to the heart become blocked, and the blood supply is slowed or stopped. The heart can’t get the oxygen and nutrients it needs. The affected heart tissue may die.

Symptoms can include chest pain (crushing, squeezing or burning pain in the center of the chest which may radiate to the arm or jaw), shortness of breath, dizziness, faintness, chills, sweating or nausea. Skin may feel cold or clammy, and patients may appear gray and look ill. Sometimes there are no symptoms.

THIS SCORE TELLS YOU the percentage of heart attack (AMI) patients who died while in the hospital.

THIS INFORMATION IS IMPORTANT because it tells you how well the hospitals take care of their heart attack patients. This measure takes into consideration several factors such as how quickly hospital staff treat a heart attack patient once they are in the emergency room.

Heart Failure (HF) Mortality

HF is a weakening of the heart’s muscle which reduces its pumping power. Your body doesn’t get the oxygen and nutrients it needs. Your heart tries to pump more blood, but over time the heart muscle walls weaken. HF is one of the most common reasons for hospitalization.

Symptoms can include shortness of breath from fluid in the lungs, dizziness, fatigue, weakness, cold and clammy skin, or rapid and irregular heartbeat. HF can result from coronary artery disease, heart attack, cardiomyopathy (heart muscle damage from infection, alcohol or drugs), or an overworked heart caused by high blood pressure, kidney disease, diabetes, or a defect from birth.

THIS SCORE TELLS YOU the percentage of HF patients who died while in the hospital.

THIS INFORMATION IS IMPORTANT because it tells you how well the hospitals take care of their heart failure (HF) patients. Since HF mortality is affected by other medical problems, including lung disease, high blood pressure, cancer and liver disease, the score measures how well the hospital can control these influences.

Pneumonia Mortality

PNEUMONIA is an inflammation of the lungs caused by an infection. Many different organisms can cause pneumonia, including bacteria, viruses and fungi. Pneumonia can range from very mild to very severe, even fatal, depending on the type of organism causing it as well as the age and current health of the individual.

Symptoms can include fever, fatigue, difficulty breathing, chills, “wet” cough and chest pain.

THIS SCORE TELLS YOU the percentage of pneumonia patients who died while in the hospital.

THIS INFORMATION IS IMPORTANT because it tells you how well the hospitals take care of their pneumonia patients. Although pneumonia is typically treated with antibiotics, sometimes in an outpatient setting, death does occur in hospitals, especially if the patient has a weakened respiratory system or other chronic health problems.

Stroke Mortality

AN ACUTE STROKE is a disruption in the blood supply to the brain. A stroke occurs when a blood vessel (artery) bringing oxygen and nutrients to the brain bursts or is blocked by a blood clot or some other particle. Within minutes, the nerve cells in that area of the brain are damaged and may die within a few hours. As a result, the part of the body controlled by the damaged section of the brain cannot function properly. There are different types of strokes.

Symptoms can include sudden numbness or weakness of the face, arm or leg, particularly on one side of the body; sudden confusion, trouble speaking or understanding, sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, loss of balance or coordination.

THIS SCORE TELLS YOU the percentage of stroke patients who died while in the hospital.

THIS INFORMATION IS IMPORTANT because it tells you how well the hospitals take care of their stroke patients. Treatment for stroke must be quick and efficient to prevent brain tissue death. The wrong treatment can be fatal, and treatment may differ depending on the type of stroke a patient has suffered. Death rates vary based on the cause and the severity of the stroke, existing illnesses, speed of arrival at the hospital, and speed of diagnosis of the type of stroke. Evidence shows that stroke mortality is affected by having pneumonia, gastrointestinal hemorrhage, and heart failure.

See http://nj.gov/health/healthcarequality/stroke/documents/stroke_mortality_nj02-05.pdf for the different types of strokes.

 

 Using the Mortality Inpatient Quality Indicator (IQI)

 Using the Information on this Website


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