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Relationship of a Quality Measure Composite to Clinical Outcomes for Patients With Heart Failure

Christ Hospital and the Ohio Heart and Vascular Center, Cincinnati, Ohio, chunge{at}ohioheart.org

Lin Guo, PhD

Department of Health Services Administration, Xavier University, Cincinnati, Ohio

Donald E. Casey, Jr, MD, MPH, MBA

Atlantic Health, Morristown, New Jersey

Cheryl Bartone, BS

Christ Hospital and the Ohio Heart and Vascular Center, Cincinnati, Ohio

Santosh Menon, MD

Christ Hospital and the Ohio Heart and Vascular Center, Cincinnati, Ohio

Syed Saghir, MD

Christ Hospital and the Ohio Heart and Vascular Center, Cincinnati, Ohio

Anubhav Mital, BS

Christ Hospital and the Ohio Heart and Vascular Center, Cincinnati, Ohio

Dean J. Kereiakes, MD

Christ Hospital and the Ohio Heart and Vascular Center, Cincinnati, Ohio

Background: To determine whether compliance with heart failure performance measures (HFPMs) is associated with short-term outcome benefit. Methods: In a cohort study, 194 patients satisfying all the HFPMs for which they were eligible were compared with 206 controls. Over 6 months, time to death and first all-cause readmission data were collected. Data were adjusted for differences in comorbidities, medications, and demographics in a multivariate model. Results: There was no difference in 6-month mortality between the 2 groups. Adjusted time to death or all-cause hospitalization (hazard ratio [HR], 0.75; 95% confidence interval [CI], 0.58-0.97; P = .03) and all-cause hospitalization (HR, 0.74; 95% CI, 0.57-0.97; P = .03) were shorter for the study group compared with control, whereas there was no difference in time to death (HR, 0.86; 95% CI, 0.66-1.11; P = .24). Conclusions: Adherence to a composite of HFPM appears to be related to a reduction in all-cause readmissions for patients with HF but not short-term mortality. (Am J Med Qual 2008;23:168-175)

Key Words: heart failure • core measures • readmissions • quality • pay for performance

American Journal of Medical Quality, Vol. 23, No. 3, 168-175 (2008)
DOI: 10.1177/1062860608315337


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