Author + information
- Georgia Barbayannis,
- Davit Sargsyan,
- Javier Cabrera,
- John B. Kostis,
- Nora M. Cosgrove,
- William J. Kostis,
- for the Myocardial Infarction Data Acquisition System (MIDAS) Study Group
Background: Public reporting of hospital quality of care scores is freely available online and frequently accessed. Studies on the relationship of process improvement reports to clinical outcomes are contradictory. We examined the association between process of care scores for myocardial infarction (MI) with outcomes of readmission for MI or death in the Myocardial Infarction Data Acquisition System (MIDAS), a statewide database.
Methods: For the years 2004 to 2013, MI process of care scores in the Hospital Performance Reports of the New Jersey Department of Health were matched to patient outcomes from MIDAS. The overall care score (the average of the scores for aspirin, beta-blocker, ARB/ACI, PCI and smoking) was used in the analyses. Logistic regression and Cox proportional hazard models adjusted for age, gender, year of admission and hospital characteristics were used (Figure).
Results: Overall process of care scores improved (p<0.0001) and the rate of outcomes decreased (p<0.0001) over time. Adjusted rates for the outcomes were higher for older age at first MI admission (HR 1.047, 95% CI 1.046-1.048, p<0.0001) and male gender (HR 1.022, 95% CI 1.004-1.041, p=0.018), and lower for teaching hospitals (HR 0.916, 95% CI 0.900-0.932, p<0.0001). Lower event rate was associated with improvement in the overall process score.
Conclusions: Improvement in process of care scores of patients with MI was associated with lower rates of MI recurrence or death. This relationship was stronger for teaching hospitals.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Acute Coronary Syndromes, Diagnosis, Management and Outcomes
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1253-344
- 2017 American College of Cardiology Foundation