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Risk-adjusted hospital mortality rates for stroke: evidence from the Australian Stroke Clinical Registry (AuSCR)

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The known Variance in patient outcomes between hospitals treating acute stroke needs to be reliably assessed. Methodology for standardising risk adjustment is evolving and requires field testing. The data in hospital admission databases are limited with regard to risk adjustment. 

The new Since 2009, the Australian Stroke Clinical Registry has captured data on stroke severity and other variables. The data have been used to improve risk adjustment when comparing hospital mortality rates; they can also be reliably linked to death registrations to compare methods for assessing risk-adjusted hospital mortality. 

The implications Including appropriate risk adjustment variables will ensure that comparisons of hospital performance regarding important patient outcomes for stroke are reliable. 

Stroke imposes a major health care burden, but the adoption of effective interventions varies widely.1 Efforts to improve the quality of stroke management rely on rigorous outcomes data2 for avoiding misleading comparisons of hospitals. To identify potentially modifiable factors, analyses must account for casemix differences and random error.3