Mortality Flashcards
3 purposes of death rates
- peer review
- patient care improvement
- provided appropriate care?
patient expires during inpatient hospitalization
inpatient death
infant who shows sign of life at birth and expires during the same admission as birth
newborn death
no sign of life at birth
fetal death
another term for fetal death
stillbirth
patient expires at a time other than during inpatient hospitalization
outpatient death
death of patient at home or en route to a hospital
outpatient death
death during outpatient procedure
outpatient death
occurs prior to complete expulsion or extraction in a hospital facility (outside the hospital not included)
hospital fetal deaths
for hospital fetal deaths, duration of _____ doesn’t matter
pregnancy
fetal deaths are only included in the _____ death rate
fetal
3 deaths not included in death rates
- DOA
- fetal
- outpatient (ER, home care, ambulatory care)
death rate should be under __%
10%
t or f. most death rates combine A&C and newborn data
t
all ip deaths are counted with no exclusions
gross
gross with exclusions
net
formula: gross death rate
IP + NB deaths/IP + NB discharges
used based on the belief that if a patient expires in less than 48 hours there was insufficient time to diagnose and treat a life-threatening disorder
net death rate
net death rates assess death based on a more adequate _____
treatment time frame
net death rate more accurately reflects the hospital’s ability to ____
save lives
formula: net death rate
(IP + NB deaths - deaths < 48 hours)
/
(IP + NB discharges - deaths < 48 hours)
the ratio of post-operative deaths to the total number of patients operated on in a given time period
post-operative death rate
postoperative death is assigned to patients expiring less than ___ days post-op
10
in postoperative death, there is uncertainty regarding these 2 causes
- complications
2. medical condition
formula: postop death rate
(# deaths < 10 days post-op)
/
(# pts operated on)
in post-op infections, the rate was based on ____
operations
in post-op deaths, the rateis based on ____ because ____
number of patients; patients can only die once
the ration of deaths caused by anesthetic agents for a period to the number of anesthetics administered for that period
anesthetic death rate
anesthetic death rate is usually tabulated ____ because relatively few occur
annually
formula: anesthetic death rate
(# deaths due to anesthesia)
/
(# anesthetics administered)
3 types of maternal deaths
- direct
- indirect
- non-obstetric
maternal death type: deaths due to pregnancy
direct
maternal death type: not directly due to obstetric causes but aggravated by the pregnant condition
indirect
maternal death type: death not related to pregnancy; woman happens to be pregnant
non-obstetric maternal death
formula: maternal death rate
# direct maternal deaths / # obstetric discharges
patient born in hospital during current admission
newborn
from birth up to 28 days of age
neonate
for stats purposes, from birth to one year of age
infant
formula: neonatal death rate
# neonatal deaths / # neonatal discharges incl. deaths
formula: infant death rate
# infant deaths / # infant discharges incl. deaths
the ratio of fetal deaths to the total number of births in a given time period
fetal death rates
fetal deaths are excluded from all ______ except _____
hospital mortality rates; fetal death rates
3 types of fetal deaths
- early
- intermediate
- late
death of a fetus weighing less than 500 grams or less than 20 completed weeks of gestation
early fetal death
death after 20 completed weeks to less than 28 completed weeks of gestation
intermediate fetal death
death after 28+ completed weeks of gestation
late fetal death
more common term for early fetal death
spontaneous abortion
t or f. spontaneous abortions are different than an induced termination of pregnancy (therapeutic)
t
more common term for intermediate fetal deaths
stillbirth
formula: fetal death rate
# \_\_\_\_ fetal deaths / # births + \_\_\_\_\_ fetal deaths
inspection of dead body to determine cause of death
autopsy
any autopsy performed by the hospital pathologist or designated physician
hospital autopsy
hospital autopsies include these 3 patients
- inpatients
- outpatients
- former patients
elected/appointed official who investigates any deaths due to uncertain or unnatural causes
coroner
t or f. a coroner is a physician
f
a physician-usually pathologist-who determines cause of death when death doesn’t occur under natural circumstances
medical examiner
examples of deaths reported to coroner
criminal/violent deaths, suicides, sudden unexpected deaths, suspicious circumstances, accidents
the ratio of inpatient autopsies to all inpatient deaths during a given period of time
gross autopsy rates
formula: gross autopsy rate
# IP autopsies + NB / # IP deaths + NB
subtraction from gross death rate of cases released to legal authorities and thus not available for hospital autopsy
net autopsy rate
if a hospital pathologist performs an autopsy on behalf of the ME is it included in the net autopsy rate?
yes
formula: net autopsy rate
# ip + nb autopsies / # ip + nb deaths - unautopsied cases released to ME
the ratio of hospital autopsies to the number of deaths of hospital patients whose bodies were available for hospital autopsy
hospital autopsy rates
hospital autopsies are performed by the ____
hospital pathologies
hospital autopsies do not include _____ that were removed from the hospital and autopsied elsewhere
coroner’s ME cases
what constitutes as a hospital patient whose body was available and autopsied?
- person treated in hospital as either IP or OP at some time in past
- DOAs
- ER patients
- other OPs
- other former hospital patients even if died elsewhere, as long as autopsied by HP
hospital autopsy rates exclude these 2 deaths
- fetal deaths
2. ME cases not in hospital and autopsied elsewhere
formula: hospital autopsy rate
(hospital ip/op deaths + hp autopsies + me cases done by hp)
/
(ip/op deaths + other deaths autopsied - ip/op ME cases not done by hp)
