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American Journal of Medical Quality
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Analysis of a Large Cohort of Health Maintenance Organization Patients With Congestive Heart Failure

Patricia Gladowski, RN, MSN

Highmark Blue Cross Blue Shield, Pittsburgh, PA, patty.gladowski{at}highmark.com

Donald Fetterolf, MD, MBA

Highmark Blue Cross Blue Shield, Pittsburgh, PA

Susan Beals, RD, RN, MPM

Highmark Blue Cross Blue Shield, Pittsburgh, PA

Mary Kay Holleran, RN

Clinical Outcomes & Performance, Highmark Blue Cross Blue Shield, Pittsburgh, PA

Sanford Reich, MD, FACC

Highmark Blue Cross Blue Shield, Pitts-burgh, PA

The aim of this article was to measure guideline compliance in the care of health plan members diagnosed with congestive heart failure (CHF). Chart review was conducted on members with a discharge diagnosis of CHF (n = 2697). Information was entered onto a scannable form designed by the health plan, which was coupled to an optical character recognition reader and entered into a database. Eighty-four percent of the patients had an ejection fraction (EF) measured. An angiotensin-converting enzyme inhibitor was prescribed to 72% of patients with an EF less than 40%. Comorbidities and other measures were evaluated and based on guideline recommendations. Most of the CHF patients in this health plan are being treated appropriately during posthospitalization for CHF. The use of a novel, cost-effective method for data collection resulted in the rapid acquisition of clinical data for analysis.

Key Words: American College of Cardiology/American Heart Association Guidelines for the Evaluation and Management of Chronic Heart Failure in the Adult • angiotensin 2 receptor blocker • angiotensin-converting enzyme inhibitor • Centers for Medicare and Medicaid Services • congestive heart failure • diastolic dysfunction • ejection fraction • Highmark Blue Cross Blue Shield • systolic dysfunction • Teleform software

American Journal of Medical Quality, Vol. 18, No. 2, 73-81 (2003)
DOI: 10.1177/106286060301800205
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