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Will I get travelling expenses? penegra 100mg price in pakistan Sir Brian, who pioneered the use of hospital standardised mortality ratios (HSMRs), as a way of measuring whether death rates are higher or lower than expected, calculated that in 2004 death rates for hospitals in England were about 22 per cent higher than the average of seven Western countries, including Canada and France. They were about 58 per cent higher than the best of the countries.