Comparing and ranking hospitals based on outcome: results from The Netherlands Stroke Survey

Background: Measuring quality of care and ranking hospitals with outcome measures poses two major methodological challenges: case-mix adjustment and variation that exists by chance. Aim: To compare methods for comparing and ranking hospitals that considers these. Methods: The Netherlands Stroke Survey was conducted in 10 hospitals in the Netherlands, between October 2002 and May 2003, with prospective and consecutive enrolment of patients with acute brain ischaemia. Poor outcome was defined as death or disability after 1 year (modified Rankin scale of ⩾3). We calculated fixed and random hospit... Mehr ...