Written Answers. - Hospital Deaths Register.
Alan Shatter
Ceist:
311
Mr. Shatter
asked the
Minister for Health and Children
the plans, if any he has to make provision for a hospital deaths register in order that details of deaths in each hospital, the age of the deceased, the cause of death are accurately recorded and the information is collated on an annual basis.
[18694/98]
The adminsitration of the registration system for births, deaths and marriages is a matter for An tArd-Chláraitheoir, Registrar-General of Births, Deaths and Marriages, and for local registrars who operate under his direction.
The Vital Statistics Regulations, 1954 (S. I. No. 280 of 1954) provide that particular information in relation to deaths be furnished to the registrar by the person requiring the death to be registered. This information is recorded on a form supplied by the Central Statistics Office, Form 102, and the particulars include the date and place of death; the name and address of the deceased person; the sex and marital status of the deceased person; the age and occupation of the deceased person.
In addition, a person registering a death will in most instances produce to the registrar a medical certificate of cause of death signed by a registered medical practitioner stating the cause of death. The registrar is obliged to record the cause of death in the Register of Deaths and will also note the cause of death on the Form 102 before sending the form and the medical certificate of cause of death to the Central Statistics Office. Where an inquest is held by a coroner in relation to a death and the coroner issues his certificate giving all the details for the registration of the death, the death is registered on foot of that information. A Form 102 is completed and is sent to the Central Statistics Office together with the coroners certificate.
I might also mention that the Hospital In-Patient Enquiry, HIPE, contains information on all discharges of patients from publicly funded acute hospitals in Ireland. The system provides detailed data on diagnosis and surgical procedures for each in-patient episode together with an indicator for discharge status which allows hospital deaths to be recorded.
Data on hospital mortality from HIPE has been used from time to time on a national basis. However, individual hospital morality rates by procedure have not, to date, been used as a performance measure. There are a number of difficulties concerning the interpretation of mortality data as a true performance indicator. Issues such as case complexity, age profile and the lack of a single patient identifier all need to be taken into account in any meaningful comparative analysis. It is my view that these data sets should principally be used at health board and hospital level, in consultation with the clinicians involved.
The health strategy identified the need for a more critical evaluation of the outcome of services through techniques, such as clinical audit. Hospital morality rates are just one of a series of instruments which can be availed of in determining quality outcomes in our hospital services. The increasing involvement of clinicians in hospital management should also facilitate this process.
I am committed to the continued development of quality indicators across the health services at regional and national level. I am also conscious that one of the basic underlying requirements in any measurement of quality will be the need for objective comparisons to be made which demonstrably improve the quality of service for individual patients.
