Hospital Standardized Mortality Ratio (HSMR)

Hospital Deaths in Canada


This indicator of health care quality measures whether the number of deaths at a hospital is higher or lower than you would expect, based on the average experience of Canadian hospitals (set at 100 in 2009). When tracked over time, this measure can indicate whether hospitals have been successful in reducing patient deaths and improving care.


Hospital Deaths, also referred to as Hospital Standardized Mortality Ratio (HSMR), is a performance indicator that hospitals in Canada have been using for many years to monitor the number of deaths occurring in Canadian hospitals, changes over time and areas for patient care improvement.


The Canadian Institute for Health Information (CIHI) currently reports HSMR data from 83 hospitals across Canada. The 2013–2014 HSMR results show that the incidence of hospital deaths has decreased for 57% of these hospitals since 2009–2010.

HSMR comparison of hospital deaths to the average Canadian experience:

Highlights from 2021–2022 data:

  • Hospital Standardized Mortality Ratio (HSMR) for Canada = 98 
  • HSMR for Ontario = 97
  • HSMR for CCH = 92

*For more information on this, and additional details about how well your health system is actually working.