Quality-indicators of hospitals and clinics in Switzerland:
Pneumonia, mortality
In the current data year, 117 Swiss hospitals provided significant, risk-adjusted mortality data for pneumonia. 36'022 patients were monitored in these hospitals by the Swiss Federal Office of Public Health (BAG). A total of 3'602 patients died in hospital. The average hospital mortality in pneumonia was thus 10.0%, the highest rate observed in one clinic was 23.8%. The Kantonsspital Nidwalden, Stans achieved the lowest mortality rate of 2.5% in pneumonia.
Direct link to source not available in English - view it in German or in French (FOPH-code: D.1.1.M)
Quality report (pdf) not available in English - view it in German or in French
Department: Acute care
About the indicator «Mortality rate»
Relative proportion of deaths in hospital for a specific intervention or disease per hospital.
The hospitals sometimes treat groups of patients with different case severity. Therefore, the FOPH determines a rate of expected deaths per hospital and procedure. For the quality comparison, we use the ratio between the expected and the actually observed deaths (per intervention and per hospital). This is called risk adjustment. For this reason, it can occasionally happen that a hospital performs better in the ranking even though it has a slightly higher percentage of deaths.
Please note that we use the FOPH data per hospital site in order to achieve the most precise statements possible.
Strengths:
A low number of deaths is the main aim of each treatment and therefore a crucial indicator for patients. A low mortality rate is an indicator of effectively avoiding complications and good treatment processes in the hospital (e.g. quality of surgical techniques, avoidance of errors and complications etc)
Limits:
Unfortunately, mortality rates are not available for all interventions. It is not sure that results are transferable to similar interventions. Also, mortality rates are only meaningful when a sufficient number of cases is reached. Especially with interventions with a low risk of death the needed number of cases is very high and is only reached by large hospitals. For small hospitals it is often not possible to give a meaningful statement (while small case numbers are per se unfavorable, especially with complex interventions). Mortality rates are risk adjusted by the BAG by age and gender of the patient (for details please see the corresponding publications by BAG). A number of specialists have criticized this form of risk adjustment as inadequate. Also it needs to be noted that differences in patterns of relocating patients can introduce bias to mortality rates.
My grandfather (86) joined the rehab after a fall. After almost three month stay he suffered from a total of 3! pneumonias. During our daily visit in the mornings there was always a draft.
Pneumonia was downplayed, although a history of pulmonary rupture was present. The patient was sent out of the emergency room after 10 minutes with the words: He should wait until it gets worse and was discharged without medication.
transl. from german, inpatient treatment in Jul.2022, date of rating: 23.07.2023
4.3
3.9