Clinical InvestigationOutcomes, Health Policy, and Managed CarePatient and hospital characteristics associated with traditional measures of inpatient quality of care for patients with heart failure
Section snippets
Get With The Guidelines program
The details of the GWTG program have been previously published.8, 9 In brief, the American Heart Association launched the GWTG initiative with the goal of improving the quality of care of patients with coronary artery disease, heart failure, and stroke. The GWTG program uses a Web-based patient management tool (PMT; Outcome, Cambridge, MA) to collect clinical data, provide decision support, and provide real-time reports. Data collected by the program include patient demographics, prior medical
Patient characteristics
There were 60,601 patients eligible for documentation of the LVEF, 49,383 for discharge instructions, 24,130 for ACEi or ARB treatment at discharge, and 10,152 for smoking cessation. A detailed list of the patient and hospital characteristics for the largest cohort (those eligible for LVEF) is displayed in the online Appendix. The mean age of the patients was 72 ± 14 years (median 75 years), half were women, and close to 70% were white. Common comorbidities included coronary artery disease
Discussion
This study examined patient- and hospital-related characteristics to identify those associated with the 4 quality measures of inpatient heart failure care reported by CMS. Recommended heart failure care was more likely in patients with certain characteristics (younger age and normal renal function) and those cared for in larger hospitals. Quality of heart failure care was not, in general, significantly associated with patients' race/ethnicity or sex. Other hospital characteristics were, with
Disclosures
Paul A. Heidenreich, MD, MS: There are no relationships to disclose.
Xin Zhao, MS: Employee of Duke Clinical Research Institute.
Adrian Hernandez, MD: Reported receiving research support from Johnson & Johnson, Medtronic, and Merck & Co; (significant), serving on the speakers' bureau for Novartis; and receiving honoraria from AstraZeneca (modest) and Medtronic (modest).
Clyde Yancy, MD: There are no relationships to disclose.
Gregg C. Fonarow, MD: Novartis consulting significant; Medtronic
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Pamela N. Peterson, MD, MSPH served as guest editor for this article.