Heart patient deaths 10 times higher at one hospital - report

Deaths among heart attack patients were ten times higher at one hospital in the State compared to the hospital with the lowest rate, a new report shows.

The Health Care Quality Indicators report released by the Department of Health today shows a wide variation among hospitals in mortality rates of stroke and heart attack patients.

It shows that one hospital had 2.1 deaths per 100 heart attack patients while another hospital 21.3 deaths per 100 cases. The hospital with the highest mortality rate is almost three times the average of 36 hospitals (7.6 per 100).

The report does not name the hospitals and the measure is a crude one, not accounting for factors such as patient age. The figures were collated over a three year period from 2008 to 2010. It looks at the number of patients who died in each hospital within 30 days of being admitted.

There were three hospitals whose heart attack mortality levels were statistically higher than expected when adjusted for age, the report shows. These were hospitals where 14.5, 11.6 and 21.3 heart attack patients per 100 died.

As a result, the hospitals were contacted by the HSE and the records and coding practices were reviewed, the report says.

The report also shows sharp differences between hospitals when it came to deaths of patients after stroke.

The highest crude rate for ischemic (clot) stroke, was one that in four patients, or 25.5 per 100, died the report shows. That is more than four times the lowest rate at a hospital (6.3 per 100) and more than double the average mortality rate (12.1 per 100).

Even when age was taken into account the same hospital had the highest mortality ratio, which was more than three times the hospital with the lowest rate.

When age was adjusted for there were four hospitals which rated significantly higher than expected, according to the report. These hospitals were contacted by the Quality and Patient Safety Directorate of the HSE to “highlight these issues”, the report says.

The Department of Health said today that there may be a number of reasons for variations between hospitals, including data quality issues. Inferences about quality of care could not be made from the report and it was important it was nor relied upon to draw conclusions, it said.

Most of the data is over five years old and was gathered before improvement to collecting and reporting of information were put in place, the Department said.

The report’s purpose was to see if the HIPE (Hospital Inpatient Enquiry System)could be used as a study on data quality. The purpose was not to examine quality of care, it said.

The Department said it will produce a report of quality indicators based on 2011- 2013 data later this year which will identify regions and hospitals.

After the report was published there was a call for all hospitals to publish indicators. This would allow for "good practice to be applauded and for improvement opportunities to be identified", Fergus Clancy, chief executive of the Mater Private Healthcare Group said.