Plot each observed mortality proportion vertically against its operation count horizontally, retaining the hospital labels. The required points, together with the target and approximate control bands used below, give the following hospital mortality funnel plot.
Figure 1.
Hospital mortality proportions against operation counts with a 20% target and approximate pointwise 95% binomial control limits
. Details.
Hospitals sharing an operation count remain separate labeled points; equal observed mortality proportions at different volumes should not be treated as equally precise.
Four advantages of the hospital mortality funnel plot are:
It does not automatically adjust for patient severity, referral patterns or data quality, and an outlying point does not establish a causal explanation.