( res are limited. Gregg C. Fonaro...)Most Hospital Performance Measures for Heart Failure Not Linked to Improved Patient Outcomes,Health

res are limited.

Gregg C. Fonarow, M.D., of the University of California Los Angeles Medical Center, and colleagues analyzed data from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) registry to determine the relationship between current ACC/AHA performance measures and relevant patient clinical outcomes, including the risk of death at 60- to 90-days after discharge, and rehospitalization rates. Follow-up data were collected from 5,791 patients at 91 U.S. hospitals between March 2003 and December 2004. Average patient age was 72.0 years, 51 percent were male and 78 percent were white. The researchers also evaluated the potential performance measure for beta-blockers at discharge among eligible patients hospitalized with heart failure.

During follow-up, 8.6 percent of the patients had died and the total death or rehospitalization rate was 36.2 percent. None of the current ACC/AHA performance measures was a significant independent predictor of death in the first 60 to 90 days after hospital discharge. Prescription of a beta-blocker at the time of hospital discharge, currently not a heart failure performance measure, was highly predictive of improved postdischarge survival (52 percent reduced risk of death) and a 27 percent lower risk of death/rehospitalization.

'These findings may have significant clinical and public health implications and suggest that additional measures may be required to more effectively quantify the quality of care provided to heart failure patients in the hospital setting,' the authors write.

'For the ACC/AHA performance measure sets to achieve their stated goal of serving as a vehicle for more rapidly translating the strongest clinical evidence into practice, better methods for identifying and validating new performance measures may be needed. As this limited set of performance measures is being used to publicly report the qualit
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