Minister says report delay down to data inaccuracies

Hospitals raise concerns over report on mortality rates after heart attacks

THE MINISTER for Health James Reilly has confirmed that a new Department of Health report on mortality rates following heart attacks has been delayed as a result of allegations of inaccurate data and concerns raised by some doctors and hospitals that it could be used to make inferences about quality of care.

Dr Reilly told the Dáil last week that the chief medical officer in his department had been working on a report entitled Health Care Quality Indicators in the Irish Health System: Examining the Potential of Hospital Discharge Data which included an examination of death rates in hospitals following heart attacks.

He said this work to date had demonstrated the value of using data drawn from the hospital in-patient inquiry system (Hipe) “as a tool to derive knowledge and understanding of healthcare quality”.

“However, this work has also uncovered variation in the accuracy of data as reported through the Hipe system. Some individual hospitals have attributed this variation to inaccuracies in the medical chart and the subsequent coding of information that is then inputted by individual hospitals to the Hipe system.

“I am concerned about this finding in relation to data quality, given its potential patient safety implications. I believe there is a duty on all hospitals to take steps to ensure that the information which they record and report is accurate.”

Dr Reilly said concerns had been raised by certain hospitals and clinicians that the report, which seeks only to examine quality of data, “could be either inadvertently or deliberately misinterpreted as making inferences on quality of care”.

“I understand this concern. However, I do not accept that the solution is to disregard these data. Where that source of information is found to be flawed, the solution is to improve it. These data have been collected by hospitals and the hospitals themselves must be accountable for the quality of them.

“Therefore, the chief medical officer, in conjunction with the HSE, is now in the process of further augmenting the analysis of the indicators to date with data for 2011 and 2012. Every public hospital in the country has been written to in order that they can ensure that the information they record and report for 2011 and 2012 is accurate. The Economic and Social Research Institute, who manage the Hipe system, provide checking and audit tools to enable hospitals to ensure the quality of their data.”

The Irish Times reported in December that a number of consultants at Beaumont Hospital were understood to have threatened legal action against the Department of Health if it pressed ahead with the publication of the report in its format at the time.

Data from the report was used to support the case for closing the emergency unit at Roscommon Hospital last year although the Government has maintained that Hipe data “came later and was not used in the original decision”.