Аннотация:In 1978-87, case fatality rates for all hospitals combined were 39.7% at 30 days and 56.9% at one year (table).In 1988-97, the corresponding figures were 32.9% and 48.9%.The table shows that case fatality rates were lower for the region's teaching hospital (I) than for all other hospitals combined.Significant differences were also seen between individual nonteaching hospitals.Variation between the teaching hospital and individual non-teaching hospitals reduced over time.Differences in case fatality rates during the first 30 days accounted for the differences between hospitals and most of the difference over time (table ).For 1988-97, the low case fatality rate for in-hospital deaths in hospital III within 30 days, calculated without data linked to death certificates, was as high as that in other hospitals when linked data were used.Otherwise, case fatality rates for in-hospital deaths were good predictors of hospitals' relative rankings when rates were calculated with data linked to death certificates (Spearman's rank correlation coefficients between in-hospital deaths and deaths anywhere at 30, 90, and 365 days were 0.83, 0.86, and 0.88 in 1987-98 and 0.93, 0.81, and 0.71 in 1988-97).Age and sex standardised case fatality rates at 30 days in 1978-87 and 1988-97 were 33.2 and 24.7 in people < 75 years and 27.5 and 19.8 in those < 65.Differences between hospitals for case fatality rates in patients < 75 and < 65 years were similar to those found for patients of all ages, although with diminishing statistical power not all comparisons reached significance (see tables A-C on bmj.com).
