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Hospital Standardized Mortality Ration (HSMR)

What is HSMR?

HSMR is an indicator and measurement tool that compares a hospital's mortality rate with the overall national average. It has been used by hospitals in many jurisdictions to assess and analyze mortality, and to identify areas for improvement.

How is HSMR calculated?

The HSMR is the ratio of actual (observed) deaths to expected deaths.

  • A number greater than 100 suggests a mortality rate higher than the national average
  • A number less than 100 suggests a mortality rate lower than the national average

What factors influence HSMR?

HSMR can be influenced by a number of factors, some of which are beyond a hospital's control. These include:

  • Structural factors: the availability of physicians, long-term care facilities, hospice, screening facilities, and public health programs may influence how and where patients are treated, and how and where patients die.
  • Population characteristics: the incidence of specific illnesses in the population a hospital serves, as well as the communities in which patients live, can influence their health status and health outcomes.

Does a high HSMR result mean that a hospital has a high number of adverse events, or is unsafe?

No. HSMR is an indicator that provides a snapshot or screening tool of what has happened with respect to one aspect of care - mortality - in a hospital/LHIN/Regional Health Authority over a certain period of time. We must also remember that not all deaths are preventable. The purpose of the HSMR is to provide useful data to support hospitals in their ongoing efforts in improving hospital performance.

A higher than average HSMR result does not necessarily mean that a hospital is "unsafe;" a lower than average HSMR does not necessarily mean a hospital is "safe." That is why it is vital that HSMR results be viewed in the context of other performance indicators.

South Bruce Grey Health Centre - HSMR



2004-2005  85.59
2005-2006  106.58
2006-2007 109.28
2007-2008  107.13

*Hospitals included in the corporation result: Durham, Kincardine, Walkerton
(Chesley is not included as the number of cases is too low)

To view the report released by CIHI, or for more information on HSMR, please visit the CIHI website.