This study compared measures of hospital performance using both administrative and clinical data sources.

Hospital-specific mortality outcomes on 10,086 patients admitted to 102 hospitals with a diagnosis of acute myocardial infarction (AMI) in Ontario was used as a test case.  Four and six hospitals were identified as having statistically significantly higher than expected mortality using administrative and clinical data, respectively, when model-based indirect standardization was used.  When using random effects models, zero and two hospitals were identified as having significantly higher mortality using administrative and clinical data, respectively.

Approximately one in four hospitals changed at least two decile rankings when clinical data were used compared to when administrative data were used.