The Midland Regional Hospital in Tullamore has the highest death rate of any hospital in the country among patients presenting with heart attacks.

This is according to the first ever published 'league table' on hospital mortality rates and other aspects of hospitals' clinical performance, just issued by the Department of Health. The report reveals considerable variations in death rates among hospitals in patients suffering heart attacks and strokes.

Department Chief Medical Officer Dr Tony Holohan, responding to the report, said, while there was no such thing as perfect data, some of the information presented in the report signalled that certain services required further analysis and examination to identify if safety and quality problems might exist.

An analysis of age-sex standardised death rates of patients within 30 days of admission with acute myocardial infarction (heart attack) shows that Tullamore has the highest age-standardised death rate, with 11.96 deaths per 100 cases.

The second-highest death rate in this category of patient, 10.36, was recorded at Cavan General Hospital, while the third highest rate was at Connolly Hospital, Blanchardstown, with a rate of 9.87.

The lowest rate recorded was at Portlaoise Hospital which had 3.84 deaths per 100 heart attack cases. The second lowest rate in this patient category was at the Mater in Dublin, which had a rate of 3.96.

Overall, the national average death rate in hospital 30 days after admission for a heart attack was 6.68 per 100 cases. The figures are adjusted to take into account the age and sex of the patient.

The mortality rates are contained in the first annual report of the National Healthcare Quality Reporting System.

The report also examined hospital death rates among patients 30 days after admission for haemorrhagic stroke (strokes cause by bleeds).

The highest death rate in this category was recorded at Naas General Hospital, which had a standardised death rate per 100 cases of 36.2, while the lowest recorded rate was at Beaumont Hospital, at 11.1 per 100 cases.

Under deaths due to ischaemic stroke (strokes caused by an interruption of blood supply to the brain) the highest rate 30 days after admission was recorded at Cavan General Hospital, which had a rate of 13.67, while the lowest rate was at Tallaght Hospital, which had a rate of 4.59.

Dr Holohan said the Department would work closely with the HSE and hospital groups to ensure the early identification and speedy rectification of any deficiencies in the health service.

It is stressed that the morality stats do not always indicate poor care, as there may be other factrs to be taken into account such as patients having other illnesses besides those with which they were admitted.

Maternity service statistics in the report show that St Luke's Hospital in Kilkenny had the highest caesarean section rate in the country, at 35.4 per 100 births, while the lowest rate 21%, was recorded at Sligo General Hospital.

Dr Holohan said the publicaiton of this safety and quality data for the first time was about promoting a culture of openness and transparency and improving accountability in the health sector.