Robin Mathews1, Gregg C Fonarow2, Shuang Li3, Eric D Peterson3, John S Rumsfeld4, Paul A Heidenreich5, Matthew T Roe3, William J Oetgen6, James G Jollis3, Christopher P Cannon7, James A de Lemos8, Tracy Y Wang3. 1. Duke Clinical Research Institute/Duke University Medical Center, Durham, NC. Electronic address: robin.mathews@duke.edu. 2. Ahmanson-UCLA Cardiomyopathy Center, University of California Los Angeles, Los Angeles, CA. 3. Duke Clinical Research Institute/Duke University Medical Center, Durham, NC. 4. Denver VA Medical Center, Denver, CO. 5. VA Palo Alto Health System, Palo Alto, CA. 6. American College of Cardiology, Washington, DC. 7. Brigham and Women's Hospital, Boston, MA. 8. University of Texas-Southwestern Medical Center, Dallas, TX.
Abstract
BACKGROUND: Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines (ACTION Registry-GWTG) was designed to measure and improve the treatment and outcomes of patients with acute myocardial infarction (AMI), yet it is unknown whether performance of Medicare Hospital Compare metrics and outcomes differ between hospitals participating versus those not participating in the registry. METHODS: Using 2007 to 2010 Hospital Compare data, we matched participating to nonparticipating hospitals based on teaching status, size, percutaneous coronary intervention capability, and baseline (2007) Hospital Compare AMI process measure performance. We used linear mixed modeling to compare 2010 Hospital Compare process measure adherence, 30-day risk-adjusted mortality, and readmission rates. We repeated these analyses after stratification according to baseline performance level. RESULTS: Compared with nonparticipating hospitals, those participating were larger (median 288 vs 139 beds, P < .0001), more often teaching hospitals (18.8% vs 6.3%, P < .0001), and more likely had interventional catheterization lab capabilities (85.7% vs 34.0%, P < .0001). Among 502 matched pairs of participating and nonparticipating hospitals, we found high levels of process measure adherence in both 2007 and 2010, with minimal differences between them. Rates of 30-day mortality and readmission in 2010 were also similar between both groups. Results were consistent across strata of baseline performance level. CONCLUSIONS: In this observational analysis, there were no significant differences in the performance of Hospital Compare process measures or outcomes between hospitals in Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines and other hospitals not in the registry. However, baseline performance on the Hospital Compare process measures was very high in both groups, suggesting the need for new quality improvement foci to further improve patient outcomes.
BACKGROUND: Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines (ACTION Registry-GWTG) was designed to measure and improve the treatment and outcomes of patients with acute myocardial infarction (AMI), yet it is unknown whether performance of Medicare Hospital Compare metrics and outcomes differ between hospitals participating versus those not participating in the registry. METHODS: Using 2007 to 2010 Hospital Compare data, we matched participating to nonparticipating hospitals based on teaching status, size, percutaneous coronary intervention capability, and baseline (2007) Hospital Compare AMI process measure performance. We used linear mixed modeling to compare 2010 Hospital Compare process measure adherence, 30-day risk-adjusted mortality, and readmission rates. We repeated these analyses after stratification according to baseline performance level. RESULTS: Compared with nonparticipating hospitals, those participating were larger (median 288 vs 139 beds, P < .0001), more often teaching hospitals (18.8% vs 6.3%, P < .0001), and more likely had interventional catheterization lab capabilities (85.7% vs 34.0%, P < .0001). Among 502 matched pairs of participating and nonparticipating hospitals, we found high levels of process measure adherence in both 2007 and 2010, with minimal differences between them. Rates of 30-day mortality and readmission in 2010 were also similar between both groups. Results were consistent across strata of baseline performance level. CONCLUSIONS: In this observational analysis, there were no significant differences in the performance of Hospital Compare process measures or outcomes between hospitals in Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines and other hospitals not in the registry. However, baseline performance on the Hospital Compare process measures was very high in both groups, suggesting the need for new quality improvement foci to further improve patient outcomes.
Authors: Ambarish Pandey; Harsh Golwala; Hurst M Hall; Tracy Y Wang; Di Lu; Ying Xian; Karen Chiswell; Karen E Joynt; Abhinav Goyal; Sandeep R Das; Dharam Kumbhani; Howard Julien; Gregg C Fonarow; James A de Lemos Journal: JAMA Cardiol Date: 2017-07-01 Impact factor: 14.676
Authors: Tanja K Rudolph; David Messika-Zeitoun; Norbert Frey; Matthias Lutz; Laura Krapf; Stephanie Passefort; John Fryearson; Helen Simpson; Kai Mortensen; Sebastian Rehse; Andreas Tiroke; Fotini Dodos; Florian Mies; Christiane Pohlmann; Jana Kurucova; Martin Thoenes; Peter Bramlage; Richard Paul Steeds Journal: Open Heart Date: 2019-07-21
Authors: Kumar Dharmarajan; Robert L McNamara; Yongfei Wang; Frederick A Masoudi; Joseph S Ross; Erica E Spatz; Nihar R Desai; James A de Lemos; Gregg C Fonarow; Paul A Heidenreich; Deepak L Bhatt; Susannah M Bernheim; Lara E Slattery; Yosef M Khan; Jeptha P Curtis Journal: Ann Intern Med Date: 2017-09-26 Impact factor: 51.598