The National Office of Clinical Audit (NOCA) launched the seventh report from the National Audit of Hospital Mortality (NAHM) in July 2023

This report presents standardised mortality ratios (SMR) for six medical conditions using data from 44 publicly funded hospitals in Ireland, with 31 hospitals meeting the criteria for inclusion in this report. There were no statistical outliers in 2021 and all hospitals were within expected ranges, despite the high numbers of COVID-19 cases in the reporting period.

Ms. Susan Moloney, Quality and Patient Safety Manager, RCSI Hospital Group commented that “RCSI Hospital Group is committed to the use of relevant data to monitor trends and identify areas for improvement across services. This data is then published on the HG website for maximal transparency. The National Audit of Hospital Mortality (NAHM) is an invaluable source of information, which allows hospitals to interrogate and compare in-hospital mortality across a number of key diagnoses. The HG is committed to using this data on an ongoing basis as it will enable us to improve the quality of the services we deliver to patients and families.”

Key findings

• Crude in-hospital mortality for AMI has declined steadily from 69 deaths per 1,000 admissions in 2012, to 48 deaths per 1,000 admissions in 2021.
• Crude in-hospital mortality for heart failure increased by 15% between 2020 and 2021, from 63 deaths per 1,000 admissions in 2020, to 73 deaths per 1,000 admissions in 2021.
• There was a significant reduction (42%) in crude in-hospital mortality for ischaemic stroke from 116 deaths per 1,000 admissions in 2012, to 68 deaths per 1,000 admissions in 2021.
• For Haemorrhagic stroke there was a 21% reduction in crude in-hospital mortality from 309 deaths per 1,000 admissions in 2012, to 253 deaths per 1,000 admissions in 2021.
• In-hospital crude mortality for COPD shows a slight increase from 38 deaths per 1,000 admissions in 2020, to 41 deaths per 1,000 admissions in 2021.
• Pneumonia crude mortality has seen a statistically significant increase from 103 deaths per 1,000 admissions reported in 2019 to 140 deaths per 1,000 admissions reported in 2021.
• Case studies identify the continued need for clearer documentation in the medical record to ensure accuracy of principal diagnosis.
• There is still a need for agreed terminology/synonyms which can be used in the medical record, in the absence of the wording ‘palliative care’, to ensure that all palliative care and end of life care cases are correctly assigned the ICD-10-AM Palliative Care Z51.5 code for inclusion in NAHM risk calculations where appropriate.

View the National Audit of Hospital Mortality Annual Report 2021

The full Annual Report is available on the National Office of Clinical Audit website. Click here to access the annual report. It is important to note that this report cannot be used to compare hospitals to one another. No two hospitals are expected to be the same, as hospitals have very different case mix or patient profiles.

View the National Audit of Hospital Mortality 2021 Summary report

The Summary Report is available on the National Office of Clinical Audit website. Click here to access the summary report

For further information regarding the National Audit of Hospital Mortality 2021 report

Please contact Ms. Susan Moloney, Quality and Patient Safety Manager at susanmoloney@rcsihoispitals.ie