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National Patterns of Risk-Standardized Mortality and Readmission for Acute Myocardial Infarction and Heart Failure: Update on Publicly Reported Outcomes Measures Based on the 2010 Release
- Publication Year :
- 2010
-
Abstract
- Background— Patient outcomes provide a critical perspective on quality of care. The Centers for Medicare and Medicaid Services (CMS) is publicly reporting hospital 30-day risk-standardized mortality rates (RSMRs) and risk-standardized readmission rates (RSRRs) for patients hospitalized with acute myocardial infarction (AMI) and heart failure (HF). We provide a national perspective on hospital performance for the 2010 release of these measures. Methods and Results— The hospital RSMRs and RSRRs are calculated from Medicare claims data for fee-for-service Medicare beneficiaries, 65 years or older, hospitalized with AMI or HF between July 1, 2006, and June 30, 2009. The rates are calculated using hierarchical logistic modeling to account for patient clustering, and are risk-adjusted for age, sex, and patient comorbidities. The median RSMR for AMI was 16.0% and for HF was 10.8%. Both measures had a wide range of hospital performance with an absolute 5.2% difference between hospitals in the 5th versus 95th percentile for AMI and 5.0% for HF. The median RSRR for AMI was 19.9% and for HF was 24.5% (3.9% range for 5th to 95th percentile for AMI, 6.7% for HF). Distinct regional patterns were evident for both measures and both conditions. Conclusions— High RSRRs persist for AMI and HF and clinically meaningful variation exists for RSMRs and RSRRs for both conditions. Our results suggest continued opportunities for improvement in patient outcomes for HF and AMI.
- Subjects :
- Male
Risk
medicine.medical_specialty
Quality Assurance, Health Care
Myocardial Infarction
Hospital performance
Patient Readmission
Article
medicine
Humans
Myocardial infarction
Hospital Mortality
Risk factor
Practice Patterns, Physicians'
Intensive care medicine
Aged
Aged, 80 and over
Heart Failure
Critical perspective
business.industry
Mortality rate
Medicare beneficiary
medicine.disease
United States
Outcome and Process Assessment, Health Care
Heart failure
Emergency medicine
Female
Cardiology and Cardiovascular Medicine
business
Medicaid
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....9077efb4ab8a787aeb663cc69792beea