GENERAL MEDICINE
Reduction in stroke mortality rates - report
July 8, 2019
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A new report has found some improvements in the health service over the last year, including a reduction in heart attack and stroke mortality rates.
However, the report also finds that there is "room for improvement" in some areas, including vaccination and Ireland's caesarean rate, which continues to rise year on year and is above the OECD average.
According to the 5th Annual Report of the National Healthcare Quality Reporting System (NHQRS), which provides an overview of quality in the health service, mortality rates for heart attack and stroke "continue to fall and are the best we have seen in 10 years".
There have also been improvements in hospitalisation rates for chronic conditions, such as heart failure and asthma, with both of these below international averages.
The health service also met its national targets for bowel cancer screening and time to surgery for patients who had broken a hip. Some 86% of people with hip fractures received surgery within two days of hospital admission.
Overall, 84% of patients said that they felt they were treated with dignity and respect during their stay in hospital.
The report also noted that Ireland compares favourably to OECD averages when it comes to certain cancers. The OECD average for breast cancer survival is 85%. Ireland's average is 84%.
The OECD average for cervical cancer survival is 62%, the same as it is in Ireland, while the OECD average for colon cancer survival is 62%, just ahead of Ireland's figure of 61%.
However, the report also states that there is room for improvement in a number of areas, such as flu vaccination rates. These rates remain below target in people over the age of 65 and during the last flu season, just 39% of healthcare workers, got the vaccine.
Healthcare workers are in the ‘at risk' group and are recommended to get the vaccine every flu season.
The report also noted that not one region in Ireland met the national target for meningitis C vaccination.
Meanwhile, it also found that more people with diabetes are being admitted to hospital, while overall, antibiotic use has increased in Irish hospitals over the last three years.
While most patients felt they were treated with dignity and respect during their hospital stay, just 35% said they received enough emotional support.
The report also expressed concern about benzodiazepine use in older people. Benzodiazepines are sedatives that are often prescribed to encourage sleep or reduce stress and anxiety.
According to the report, use of these drugs in people over the age of 65 is higher than international averages, and use in women over the age of 65 is 40% higher than in men.
It also noted that caesarean rates increased between 2007 and 2016. In 2016, the rate was 31.4 per 100 live births, which was above the OECD rate of 27.7.
The highest rates in Ireland in 2016 were in Cavan General Hospital (38.4 per 100 live births), St Luke's General Hospital (38.3) and South Tipperary General Hospital (36.4).
The lowest rates were found in Wexford General Hospital (25.9), University Hospital Waterford (26.8) and the Midland Regional Hospital Portlaoise (27).
Commenting on the report, the Minister for Health, Simon Harris, said that it is important that these findings are used to "highlight the areas of healthcare that are performing well, but we also must review areas where we can perform better, examine possible causes and take follow-up actions".
"For example, there are improvements to be made in our immunisation rates. Vaccine hesitancy is not unique to Ireland. It is a global issue and has been identified by the World Health Organization as one of the 10 leading threats to global health in 2019," he commented.
According to the NHQRS, this report is designed to be used by healthcare service providers and policy makers to identify trends in healthcare quality and patient safety. It can be viewed in full here.