Survival rates improved in centers combining high-quality AMI, HF care
MedWire News: Hospitals that provide superior care for both acute myocardial infarction (AMI) and heart failure (HF) patients have better survival rates than those that provide superior care for only one of these conditions, say researchers.
The study, published in the Journal of the American College of Cardiology, involved 283 hospitals participating in the American Heart Association's Get With the Guidelines (GWTG) Program between January 2005 and April 2009.
It examined how well hospital performance for AMI and HF care correlates, and whether adherence to core measures for treatment of these conditions results in better patient outcomes.
The findings showed that the hospitals' median adherence to core measures for AMI and HF were 93.2% and 92.1%, respectively.
However, there was only a modest correlation between the two care processes, with only 18% of hospitals having superior adherence (defined as the upper tertile of adherence) to both care measures, and 51% having superior adherence to neither.
Hospitals with superior adherence to both AMI and HF measures had a lower in-hospital mortality rate, at 3.3%, than those with superior adherence to neither measure, at 4.2% (p<0.0001). This association remained significant after adjusting for patient and hospital characteristics.
Further analysis showed that hospitals with superior adherence to just one measure had similar mortality rates to those with superior adherence to neither measure.
These findings indicate that the quality of a hospital's care may be more accurately reflected by its adherence to a set of combined cardiovascular disease measures rather than a single set of performance measures, say Tracey Wang (Duke Clinical Research Institute, Durham, North Carolina, USA) and co-authors.
"Further investigation and refining of quality improvement strategies is needed to optimize the consistency of hospital quality of cardiovascular care," they conclude.
MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011
By Piriya Mahendra