Hospital performance recognition with the Get With The Guidelines Program and mortality for acute myocardial infarction and heart failure - 12/08/11
, William R. Lewis, MD b, Kenneth A. LaBresh, MD c, Lee H. Schwamm, MD d, Gregg C. Fonarow, MD eRiassunto |
Background |
Many hospitals enrolled in the American Heart Association's Get With The Guidelines (GWTG) Program achieve high levels of recommended care for heart failure, acute myocardial infarction (MI) and stroke. However, it is unclear if outcomes are better in those hospitals recognized by the GWTG program for their processes of care.
Methods |
We compared hospitals enrolled in GWTG and receiving achievement awards for high levels of recommended processes of care with other hospitals using data on risk-adjusted 30-day survival for heart failure and acute MI reported by the Center for Medicare and Medicaid Services.
Results |
Among the 3,909 hospitals with 30-day data reported by Center for Medicare and Medicaid Services 355 (9%) received GWTG achievement awards. Risk-adjusted mortality for hospitals receiving awards was lower for both heart failure (11.0% vs 11.2%, P = .0005) and acute MI (16.1% vs 16.5%, P < .0001) compared to those not receiving awards. After additional adjustment for hospital characteristics and noncardiac performance measures, the reduction in mortality remained significantly lower for GWTG award hospitals for acute myocardial infraction (−0.19%, 95% CI −0.33 to −0.05), but not for heart failure (−0.11%, 95% CI −0.25 to 0.02). Additional adjustment for cardiac processes of care reduced the benefit of award hospitals by 28% for heart failure mortality and 43% for acute MI mortality.
Conclusions |
Hospitals receiving achievement awards from the GWTG program have modestly lower risk adjusted mortality for acute MI and to a lesser extent, heart failure, explained in part by better process of care.
Il testo completo di questo articolo è disponibile in PDF.Mappa
| Raymond J. Gibbons, MD served as guest editor on this manuscript. |
Vol 158 - N° 4
P. 546-553 - Ottobre 2009 Ritorno al numero
Articolo precedente
- Differential effects of afterload on left ventricular long- and short-axis function: Insights from a clinical model of patients with aortic valve stenosis undergoing aortic valve replacement
- Shemy Carasso, Oved Cohen, Diab Mutlak, Zvi Adler, Jonathan Lessick, Shimon A. Reisner, Harry Rakowski, Gil Bolotin, Yoram Agmon
- Cardiovascular events with absent or minimal coronary calcification: The Multi-Ethnic Study of Atherosclerosis (MESA)
- Matthew J. Budoff, Robyn L. McClelland, Khurram Nasir, Philip Greenland, Richard A. Kronmal, George T. Kondos, Steven Shea, Joao A.C. Lima, Roger S. Blumenthal
Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
L'accesso al testo integrale di questo articolo richiede un abbonamento.
Già abbonato a @@106933@@ rivista ?