MONTREAL-At four of Quebec's hospitals, people are more likely to die than just about anywhere else in Canada.

That's according to data from the Canadian Institute of Health Information.

For the past seven years the CIHI has been keeping track of mortality ratios with a goal to measure how Canadian hospitals are performing in terms of their death rates.

Compared to just over 100 hospitals across the country, some of Quebec’s hospitals didn't fare very well.

CIHI stresses most hospitals including the MUHC, CHUM and the Jewish General have better-than-expected death rates and the reasons why some Quebec hospitals are higher could relate to both external and internal factors such as aging populations and more difficult healthcare challenges.

But of the eight hospitals with the worst death rates, four were in Ontario and four were in Quebec.

They are Verdun Hospital, St. Jerome Regional, the Pavillion St. Joseph in Trois-Rivieres. The highest death rate in the country is at Gatineau's Health and Social Services Centre.

Officials at Gatineau hospital said they have a good explanation: the population they serve.

“We have a very high rate of smokers. people not eating enough fruit and vegetables; less than in the rest of Quebec. We also have a high rate of chronic diseases. I'm talking about diabetes, hypertension and cholesterol,” said Renee Amyot, of the CSSS Gatineau.

In St-Jerome, officials said they did not know why their mortality rate was so high but they are looking at it seriously.

“We will have to study it a little bit more to really understand why we have this number,” said Dr. Lucie Poitras of the St-Jerome Hospital.

At Verdun Hospital they are also studying the results.

Since 2006, CIHI has used a British model for measuring hospital mortality rates in Canadian hospitals. 2010-2011 was the first year Quebec hospital numbers fit that model.

“It took us a couple of years to adapt the methodology to make Quebec comparable,” said Claude Lemay of the CIHI.

Quebec's health minister is also studying the results to see what they mean and how they might be improved.