The risk of a patient dying in hospital from heart attack, a type of stroke or pneumonia has fallen significantly over the past decade, according to the latest report from the National Office of Clinical Audit (Noca). This is not just good news for patients; it is a welcome reflection of the kind of data-gathering that is now taking place in the health service. For too long, detailed data on hospital outcomes was not available.
As might be expected, it is not all good news for the diseases focused on by the report. The death rate from chronic obstructive pulmonary disease (COPD) has remained unchanged, while the rate for heart failure fell by just 6 per cent over the past 10 years.The different in-hospital mortality rate for the two main types of stroke is unsurprising: death from ischaemic stroke, which occurs when a clot travels to the brain from outside the organ, has fallen 38 per cent over the past 10 years, from 123 deaths to 76 per 1,000 admissions, while the mortality rate for haemorrhagic stroke showed a reduction of 17 per cent, from 302 to 252 deaths per 1,000 admissions.
Dedicated stroke units, available in most acute hospitals, have contributed greatly to the reduction in death rates for both types of stroke. But it is the availability of clot-busting drugs in the initial treatment of patients with ischaemic stroke that accounts for the greater chance of a patient with this kind of stroke leaving hospital alive.
Those hoping for the first Irish league table of comparative public hospital performance will, however, be disappointed. Noca says this would be inappropriate as specialist referral centres have a greater number of patients who are sicker. However, using standardised data, future reports could usefully look at comparing outcomes between similar sized general hospitals.
Noca deserve praise for producing an accessible report. Alan Egan, the public and patient interest representative with Noca writes how he was facilitated in making the report as readable as possible for the public. It is a constructive acknowledgment of public engagement by the agency.