The Canadian Institute for Health Information (CIHI) began to adapt and validate the HSMR measure for use in Canada in 2005 at the request of hospitals and patient safety experts. The HSMR is calculated as a ratio of the actual number of deaths to the expected number of deaths among patients in acute care hospitals.

The Formula for HSMR is equal to the number of observed deaths divided by the number of expected deaths, multiplied by 100.

An HSMR equal to 100 indicates that there is no difference between the hospital's mortality rate and the overall average rate; greater than 100 suggests that the local mortality rate is higher than the overall average; less than 100 suggests that the local mortality rate is lower than the overall average.

The HSMR is based on diagnosis groups that account for 80% of all deaths in acute care hospitals. The HSMR is adjusted for other factors affecting mortality, such as age, sex, and length of stay.

• Hospital Standardized Mortality Ratio (HSMR)  [PDF]
  English | French
• CIHI HSMR Reports [December 11, 2008]
  English | French

Hospitals reported (by Corporation) in CIHI's HSMR Report