Hospital Standardised Mortality Ratio (HSMR)

The majority of deaths that occur in hospital are inevitable because of the patients’ conditions on admission. However, some deaths can be prevented by improving care and treatment or by reducing healthcare related harm.

An aim of the Scottish Patient Safety Programme is to reduce hospital by 20% by December 2015.

In order to monitor progress in relation to this aim, the Information Services Division was asked to develop the Hospital Standardised Mortality Ratio for Scottish hospitals. Since December 2009, Public Health & Intelligence has published, quarterly, HSMRs for all acute hospitals participating in the Scottish Patient Safety Programme.

Healthcare Improvement Scotland and Public Health & Intelligence systematically review the latest HSMR figures each quarter.

The Scottish HSMR uses the routine linkage of data obtained from hospital discharge summaries to death registrations, the latter held by the National Records of Scotland. The HSMR is a measurement tool where crude mortality data are adjusted to take account of some of the factors known to affect the underlying risk of death. The HSMR is calculated as the ratio of the actual number of deaths within 30 days of admission to hospital (irrespective of place of death) to the predicted number of deaths: HSMR = observed deaths/predicted deaths. Further details of how the Scottish HSMR is produced are available from the website of Public Health & Intelligence

In 2011, Healthcare Improvement Scotland produced a guide for NHS boards on using the HSMR.

In 2014 we lead a short life working group to make recommendations on the Hospital Standardised Mortality Ratio (HSMR) in Scotland.

HSMR recommendations

Access a report from our short life working group for recommendations on the Hospital Standardised Mortality Ratio in Scotland.