Hospital Standardized Mortality Ratio (HSMR)

The hospital standardized mortality ratio (HSMR) is an important measure to improve patient safety and quality of care in Canadian hospitals.  

The HSMR adjusts for factors that affect in-hospital mortality rates, such as patient age, sex, diagnosis, length of stay, comorbidities and admission status. It then compares the actual number of deaths in a hospital with the average Canadian experience. The ratio provides a starting point to assess mortality rates and identify areas for improvement to help reduce hospital deaths.

When tracked over time, the ratio can be a motivator for change. The HSMR indicates how successful hospitals and health regions have been in reducing inpatient deaths — leading to improved patient care. CIHI has led the effort in calculating HSMRs for Canada and publishes results for eligible facilities and regions in all provinces and territories.

We welcome your feedback and questions

• Contact us at hsp@cihi.ca.
• Have a data inquiry or research question? Make a custom data request.

HSMR information

 Reports and analyses
 Methodology

Reports and analyses about HSMR

• See the HSMR results in Your Health System
• In Focus: A National Look at Sepsis (Dec. 2009)
• HSMR: A New Approach for Measuring Hospital Mortality Trends in Canada (Nov. 2007)

Methodology for HSMR

• Methodology Notes (PDF, reference years 2018–2019 to 2020–2021)
• Frequently Asked Questions for Hospitals and Health Providers
• Hospital Standardized Mortality Ratio (Hospital Deaths): 2019 re-baselining of HSMR results (PDF)