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American Heart Association/American Stroke Association Latest Quality Research
Paul A. Heidenreich, Xin Zhao, Adrian F. Hernandez, Clyde W. Yancy, Gregg C.
Fonarow Patient and hospital characteristics associated with traditional measures
of inpatient quality of care for patients with heart failure. American Heart Journal,
Volume 163, Issue 2, February 2012, Pages 239-245.e3

This study examined the care of patients in Get With The Guidelines®-Heart Failure
to determine which patient and hospital factors are associated with better process of
care as defined by Medicare.

The Medicare process of care measures include assessment of left ventricular
ejection fraction (LVEF), use of angiotensin converting enzyme inhibitors or
angiotensin receptor blockers (ACEi/ARB) if the LVEF is < 40%, , discharge
instruction, and smoking cessation counseling.

After adjustment for patient and hospital characteristics, older patients and those with
evidence of renal failure were significantly less likely to receive recommended care.

Patients with higher body mass index were more likely to receive ACEi/ARB and
discharge instructions, but less likely to have LVEF documented or to receive
smoking cessation counseling.

Small hospitals (<200 beds) were less likely to provide each of the performance
measures compared to larger hospitals.

Programs to improve evidence-based care for heart failure should consider
interventions specifically targeting and tailored to smaller facilities and patients that
are older with comorbidities.
Read acticle
Dr. Heidenreich Bio
Dr. Paul Heidenreich is Professor of Medicine and Health Research and Policy at the
Stanford University School of Medicine and Staff Cardiologist at the VA Palo Alto Health
Care System.
Dr. Heidenreich is chair of the Get With The Guidelines Quality Improvement subcommittee. He directs the VA's Chronic Heart Failure Quality Enhancement Research
Initiative, a center whose goal is to improve the quality of heart failure care throughout the
VA system. Dr. Heidenreich has an extensive background in health services research in the
areas of evidence-based medicine, quality improvement, and cost-effectiveness research.
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