Tony Gregory (Dublin Central, Independent)
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Question 170: To ask the Taoiseach if the number of death certificates of persons who died in nursing homes in what was the Eastern Health Board region which contains a reference to decubitus ulcers can be established; and if he will make a statement on the matter. [39989/06]

Tom Kitt (Dublin South, Fianna Fail)
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Mortality statistics are classified by the Underlying Cause of Death. The Underlying Cause of Death is defined as a) 'the disease or injury which initiated the train of events leading directly to death', or b) 'the circumstances of the accident or violence which produced the fatal injury'. Deaths are coded according to the Ninth Revision of the International Statistical Classification of Diseases, Injuries and Causes of Death (I.C.D. 9). Thus, numbers of deaths where decubitus ulcers were the Underlying Cause of Death can readily be produced.

However, data on diseases which were referred to on the death certificate but which were not the Underlying Cause of Death are not retained on CSO systems. To produce statistics retrospectively on numbers of death certificates containing a reference to decubitus ulcers would involve manually re-examining each death certificate. The Central Statistics Office currently retains death certificates from 2002 to date. Death certificates prior to 2002 are held by the General Register Office.

Statistics on the place of death are produced on the basis of a textual description of the place of death which is subsequently coded within the CSO according to the following classification:

1. Hospital

2. Local Health Board Institutions

3. Private Homes

4. Rotunda, Holles Street and Coombe

5. Homes for the Aged, Community Care, and Hospices

6. Mental Hospital

7. Domiciliary

8. Elsewhere.

There is no specific category within the classification for Nursing Homes. Some will be included in category '1. Local Health Board Institutions', '4. Private Homes' and '6. Homes for the Aged, Community Care and Hospices'. Thus, numbers of deaths in nursing homes cannot currently be produced without a manual re-examination of the death certificate. However even a re-examination of the death certificate may not facilitate the identification of all nursing homes as the quality and level of information provided in the textual description may not be adequate to meet this requirement. In addition an exhaustive list of nursing homes would be required to aid the coding process.

Note also that where a nursing home resident dies in a hospital, the place of death recorded will be the hospital. The residence of the deceased could potentially indicate whether or not the individual was being cared for in a nursing home prior to death. However no information on the length of stay in the hospital is available and therefore it would not be possible to identify if the decubitus ulcers occurred in the nursing home or in the hospital.