Palliative care coding practices in Canada since the introduction of guidelines and the HSMR indicator.
Bottom Line: National HSMR declined by 22% during the study period, compared with a 17% decline in HSMR-PC.Provincial results for HSMR-PC are not significantly different from regular HSMR calculation.Aside from PC coding practices, we note numerous independent drivers of improving HSMR results, notably, a significant reduction of in-hospital mortality, and increase in admissions accompanied by a greater number of coded comorbidities.
Affiliation: Canadian Institute for Health Information, Toronto, Ontario, Canada.Show MeSH
Related in: MedlinePlus
Mentions: Nationally, the HSMR declined by 22% between 2006–2007 and 2012–2013. HSMR results improved for all provinces, with the largest improvements seen in Ontario (31 points, from 120 (95% CI 118 to 121) to 89 (95% CI 88 to 90)), Nova Scotia (27 points, from 133 (95% CI 128 to 138) to 106 (95% CI 102 to 110)), Newfoundland and Labrador (24 points, from 134 (95% CI 127 to 141) to 110 (95% CI 104 to 116)) and British Columbia (23 points, from 108 (95% CI 106 to 110) to 85 (95% CI 84 to 87)) (figure 2). Provincial reductions in crude mortality among HSMR cases for the same time period were highest in Ontario (−20.3%) Nova Scotia (−17.7%) and Manitoba (−14.8%).
Affiliation: Canadian Institute for Health Information, Toronto, Ontario, Canada.