KEY POINTS:
When New Zealand outshone the club of Western nations in a graph of deaths following heart-attack treatment, Health Minister David Cunliffe basked in the reflected glory.
"It shows that cardiac health services in this country are among the best in the world," he told Parliament.
But a leading heart specialist is sceptical of the data and even a Ministry of Health official has questioned New Zealand's top placement on the Organisation for Economic Co-operation and Development graph.
"I was a bit surprised when we were number one," said the ministry's director of clinical benchmarking and performance, Colin Feek. "It may be that there are some counting issues between different countries."
The November OECD report says New Zealand had the lowest rate of death in the days following heart-attack treatment in hospital in 2005. It is a measure of the quality of health systems, but it seems at odds with other figures in the report:* New Zealand's below-average placing for a related statistic on the death rate following hospital admission after a stroke, and* The country's high overall death rate from constricted heart arteries.
Dr Feek said New Zealand's stroke placement, at around 19 out of 23 countries, was more in line with expectations, being close to its placing at 22nd out of 30 for economic output per head, a determinant of national health status.
Professor Harvey White, the director of coronary care and cardiovascular research at Auckland City Hospital, said New Zealand's low in-hospital death rate after heart attacks would reflect some elements of better care, but hospital stays here were shorter, skewing the figures because a greater share of deaths would be after hospital.
Also, the way heart attacks were measured in New Zealand meant much smaller heart attacks would be picked up.
Dr Feek said that despite the report's wording, the New Zealand data included deaths at home.
The report shows New Zealand remains among the worst countries for death rate from constricted heart arteries, which reflects its wealth level and lifestyle factors such as smoking, obesity and high saturated-fat consumption.
Among men, New Zealand was 23rd out of 27 on this statistic in 2004. For men and women together, the rate was 133 deaths per 100,000 population in 2001, far worse than Australia on 91 in 2003. Australia's 52 per cent improvement in the preceding 20 years was greater than New Zealand's 49 per cent.
Professor White maintained this related to New Zealand's lower spending on newer heart drugs, such as some statins - the report confirms the country's comparatively low drug spending - and lower intervention rate to treat diseased heart arteries.
Counted together, New Zealand did 187 heart artery bypass operations and angioplasties (balloon expansion of heart arteries) per 100,000 population, compared with the OECD average of 249.
Professor White said these revascularisation procedures reduced mortality in some groups, but the ministry's Dr Feek said: "A lot of the evidence suggests these operations aren't life-saving; they're about quality of life."
