Wanganui's high hospital mortality rate is no reflection of the quality of its care, an American surgeon and lawyer says.
But Steven Martyak said he believed the high number of admissions to hospitals from rest homes, combined with errors in reporting, were responsible for the mortality rate, which is the fifth highest in New Zealand.
Based on information from the Ministry of Health, the figures show that in 2010-11, 1.61 per cent of patients, a total of 156 people, admitted to Wanganui Hospital died within 30 days of admission. That is the standardised rate, which indicates actual mortality numbers versus expected mortality numbers.
The New Zealand average standardised hospital mortality rate is 1.48 per cent.
Concerned by those figures, the Whanganui District Health Board commissioned an independent external review to be carried out by Dr Martyak who works in the United States, Australia and New Zealand.
Dr Martyak was at the WDHB meeting last Friday to discuss his draft review with board members.
He told board members Wanganui Hospital met the New Zealand standard of care for its patients. "The problem is that mortality can be seen as a indication of the quality of care, but that is not accurate. Most science now uncouples patient care and patient mortality," he said.
He said the hospital had an excellent process around reviewing deaths that happened in the hospital, including contacting the families of every person who died.
Between 2010 and 2012 the hospital had more than 12,000 admissions, of which 432 patients died. Dr Martyak said he had examined those deaths carefully, and he believed only 16 may have had a "preventable factor".
He said around 18 per cent of admissions to the hospital came from rest homes.
"Now I don't have the data for other DHBs, but that seems very high. So what we're seeing is a lot of patients coming to the hospital who are in their last year of life."
He said Wanganui had the highest rate in the country of hospital admissions for people over the age of 75.
There were aggravating factors, such as 61 per cent of Wanganui's population being among New Zealand's poorest people, and the Whanganui DHB having the lowest increase in healthcare funding of any DHB.
But Dr Martyak said the mortality figures were also compounded by a measurement error at the hospital.
"Staff are not describing patients who are moving to palliative care accurately, and better recording of this is needed.
"If it was accurately recorded that the patient was being given palliative care, those patients would not be included in the mortality statistics," he said.
Dr Martyak's review will be peer reviewed by National Health Service staff in Scotland. His review will be made public once it is final.