Dáil Éireann Debate, Tuesday - 24 March 2015
561. Deputy Lucinda Creighton asked the Minister for Health the steps he is taking to address the average in-hospital mortality rates for persons who experience strokes which are higher than the average in the Organisation for Economic Co-operation and Development area; and if he will make a statement on the matter. [11191/15]
Amharc ar fhreagraThe first annual report of the National Healthcare Quality Reporting System reported that the age sex standardised in-hospital mortality rate within 30 days of admission for haemorrhagic stroke has remained almost unchanged over the ten year period from 2004 to 2013, with 24.4 deaths per 100 cases in 2004 compared to 24.6 in 2013; however, it also reported that the age sex standardised in-hospital mortality rate within 30 days of admission for ischaemic stroke has decreased from 11.2 deaths per 100 cases in 2004 to 9.7 in 2013, a reduction of 13.6%. This reduction is indeed welcomed.
A National Clinical Care Programme for Stroke was started in 2010; its aim is to improve patient healthcare and outcomes and it can point to some very positive achievements. Emergency clot-busting thrombolysis therapy is provided now to patients in all regions of the country by improved hospital and ambulance protocols, health professional training and the appointment of new physicians. There is National 24/7 access to safe stroke thrombolysis, the rate of which has increased from 1% in 2006 to a current rate of 11%. This exceeds the national target of 9% and is amongst the best in national rates worldwide.
Access to stroke unit care has been shown to improve stroke patient outcomes through reduced rates of death, dependency and shorter lengths of stay. Since the commencement of the National Clinical Programme for Stroke, nine new stroke units have been opened. This brings the total number of stroke units in acute hospitals to twenty-four. It is a major improvement from the first national stroke care audit report in 2006 which reported one stroke unit in the country.
Meanwhile, less stroke patients are dying in hospital; the rate has dropped from 16.1% in 2009 to 15.1% in 2013; this represents an average of three fewer deaths per month in 2012. There are less stroke patients being discharged to nursing homes – an indication of improved disability outcomes; more stroke patients are being discharged home directly from acute hospitals; and the average acute hospital length of stay for stroke has fallen from 10 days in 2009 to 9 days in 2013.
Of course the risk factors for stroke and other diseases are smoking, alcohol, poor diet leading to overweight and obesity, and physical inactivity. Prevention of stroke is therefore key. The work of my Department's Special Action Group on Obesity and Healthy Ireland on, among other priorities, its physical activity strategy this year, along with legislation on smoking and reducing alcohol consumption, are all intended to help prevent disease - including stroke.
