This year, for the first time, the Canadian Institute for Health Information (CIHI) has published 30-day in-hospital case fatality rates for acute myocardial infarction (AMI) comparing health regions across Canada (CIHI 2001). These were calculated on a regional basis (using the place of residence of the patient), not on the basis of individual hospitals or providers. To make them as comparable as possible these rates were adjusted for age and sex and certain co-morbid conditions (e.g. cancer, stroke, renal disease, diabetes, cardiogenic shock, and arrhythmia). It is the intent of this article to discuss the reasons for publishing such data and to consider the possible implications for hospitals, rather than to present the detailed methodology (which is based on that developed at the Institute for Clinical Evaluative Services (Tu 1999)).
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