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Health Editor
A wide variation in heart attack survival rates for Scottish hospitals is revealed by Government figures released yesterday.
Although Robert Kendell, Scotland's Chief Medical Officer, yesterday urged the public not to compare hospitals on the basis of figures, doctors are expected to study them closely.
They show, for instance, that the Monklands and Bellshill NHS Trust Hospitals, in Lanarkshire, had the highest proportion of deaths within 30 days of admission for heart attacks. The survival rate was 74.4 per cent, compared to the Scottish average of 79.8 per cent.
The Borders General Hospital NHS Trust had the best survival rate, at 84.3 per cent, followed by Edinburgh's Western General Hospital with 83.9 per cent.
The figures also show that hospitals in Edinburgh, Fife, and Argyll had a comparatively high percentage of patients who needed emergency re- admission within a month of being discharged after treatment. Around 14 per cent of patients from the Argyll and Bute NHS Trust were back within 28 days of discharge.
At Fife Healthcare Trust, the figure was 13.6 per cent, while at Edinburgh Royal Infirmary, 13.8 per cent of patients needed to be brought back.
Overall, 72,947 patients were taken back to hospitals within 28 days - 11 per cent of the 655,272 who had been treated in an adult medical speciality.
Mr Kendell warned that the figures could be misleading, because hospitals had different standards for recording such data, he said.
For example, those that included minor heart attacks would have a better survival rate than those which recorded only serious attacks.
However, the information will be used by doctors and clinicians to give them some indication of how their hospital compares with others, the Scottish Office said.
The data, covering the period from 1991 to 1994, refers to 16 "outcome indicators" (including suicide, abortion, cervical cancer mortality, death after hip fracture, stroke, etc) for health boards, acute hospitals and psychiatric hospitals.
The data on acute hospitals will be crucial for health boards in deciding how to spend their money.
"We expect the health boards to take a close interest in these figures. It is they who have to decide where they are placing their contracts for the treatment of various conditions and we expect [them] to ask questions of their providers," said Dr Kendell.
"They might say we are very interested in your explanation of why you appear to be getting worse results for treating patients with, let us say, heart attacks than your neighbouring hospital, three miles along the road."
Dr Kendell advised health boards to carry out their own audits, to see if there was a reason for differences in figures, and if they were not satisfied, change to a different hospital.
Lord James Douglas- Hamilton, the Scottish health minister, said he was confident that publishing the figures would result in improvements in health care.
"This report is not about league tables of good or bad hospitals. It is about identify- ing factors that might be changed in order to improve the results for patients across Scotland."
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