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Mortality rates higher for stroke victims at Victoria hospitals

Apr 04 2012

Victoria General and Royal Jubilee hospitals continue to have above average 30-day mortality rates for patients who have suffered strokes, but are doing slightly better with regard to readmissions to hospital following hip replacements, according to a new study released today.

The Canadian Institute for Health Information’s acute-care hospital reporting project today released a study that compares large, medium, small and teaching hospitals.

The study includes 95 per cent of all hospitals in Canada and uses a series of 21 clinical indicators and nine financial indicators “that allow hospitals to compare their performance against those of their peers.”

Kira Leeb, director, health system performance, at the Canadian Institute for Health Information, said the study includes Canada’s small hospitals, which make up 60 per cent of hospitals in the country.

“The fact that this study is so comprehensive across Canada is most exciting for us,” Leeb said. Such data weren’t available and couldn’t be collated and analyzed a decade ago. Moreover, the Canadian health-care system didn’t seem ready for a conversation on such a comparison for best practices, Leeb said.

In B.C. there are good news stories and areas in which the province should be paying attention, Leeb said.

“From a provincial perspective, nursing-sensitive adverse events (pneumonia, urinary tract infections, falls and pressure ulcers) is higher than the national average for both medical and surgical patients, Caesarean section rates are also higher; overall readmission is higher from a national perspective; and obstetrical readmission is higher,” Leeb said.

The Vancouver Island Health Authority maintains comparing hospitals offering different services to different demographics isn’t helpful and the study is more useful in allowing the health authority to chart “its performance over time.”

Generally the study shows Canada-wide hospitals saw fewer deaths after major surgery, heart attack and stroke; fewer readmissions after heart attack, stroke, and hip and knee surgery; and fewer cases of in-hospital hip fracture in 2010 than in 2007.

On Vancouver Island, the contentious C-section rate has been falling since 2007.

The C-section rate — which excludes moms who delivered pre-term infants or who gave birth to multiple children — at Victoria General and Royal Jubilee hospitals, has fallen to 28.5 per 100 live births from a high of 30 in 2007-08. However, there were slightly more C-sections in 2010-11 over 2009-10, which hit an overall low of 27.86, according to the study.

“So it’s gone up slightly since 2009-10,” said Leeb.

The Canadian average is 26.94 per 100 live births.

For large community hospitals: Victoria General and Royal Jubilee hospitals — which are lumped together as one in this study — continue to under-perform (under the 50th percentile) with regard to the 30-day mortality rate after strokes, but are doing slightly better than 2009-2010 with regard to the number of people readmitted 90 days after a hip replacement, according to the study.

Nanaimo Regional General Hospital is doing worse in certain categories than last year — still under-performing with regard to readmission rates after acute myocardial infarctions, and readmission rates after both hip and knee replacements but has improved slightly with regard to the five-day mortality rate following major surgery.

In terms of success, Victoria General and Royal Jubilee are above average in the area of readmission rates following acute myocardial infarctions and knee replacements.

Overall, the study shows that performance in Canada’s hospitals is moving in the right direction for many of the measures in the report, but there are substantial variations, according to CIHI.

The study can be found at www.cihi.ca after noon today.

ceharnett@timescolonist.com

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