HIPE and palliative care programme working on terminology for healthcare records

The Hospital In-Patient Enquiry Scheme (HIPE) is collaborating with the HSE Clinical Programme for Palliative Care to identify terminology to denote palliative care in the healthcare record in the absence of the words “palliative care” or “palliation”.

The National Audit of Hospital Mortality (NAHM) annual report for 2021, which was published in July, noted a recommendation in its 2018 report to develop accepted documented terminology. This was required to provide the evidence needed for coders to apply the palliative care code, which is one of the factors included in the risk methodology in the NAHM. Work on the matter had to be paused due to Covid-19, followed by the cyberattack on the HSE in May 2021.

A HSE spokesperson told the Medical Independent the Healthcare Pricing Office (HPO) HIPE team is engaging with the HSE Clinical Programme for Palliative Care on this issue.

“The HPO and Clinical Programme met in June 2023 to agree the next steps to progress this recommendation. This will include further analysis on palliative care HIPE data along with engagement with other clinical specialities to identify reliable terminology and indicators that can assist HIPE coders apply the palliative care code.”

The NAHM report for 2021 was the seventh year of the audit, which is published by the National Office of
Clinical Audit.

Analysis of the data showed that crude in-hospital mortality for acute myocardial infarction and ischaemic and haemorrhagic strokes had declined over the last 10 years. However, crude mortality for heart failure increased significantly (15 per cent) between 2020
and 2021.

“There is insufficient data at present to establish the reason for this increase, but it will be monitored and if it continues to increase it will be reported on in the future,” according to the report.

Dr Anne Dee, NAHM Clinical Lead, commented: “NAHM continues to strive for transparency and improvements in mortality outcomes for inpatients. This report and future reports will be essential to monitor in-hospital mortality in Ireland.”