Relationship of a quality measure composite to clinical outcomes for patients with heart failure

Am J Med Qual. 2008 May-Jun;23(3):168-75. doi: 10.1177/1062860608315337.

Abstract

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.

MeSH terms

  • Aged
  • Cohort Studies
  • Female
  • Guideline Adherence / statistics & numerical data*
  • Heart Failure / mortality
  • Heart Failure / therapy*
  • Humans
  • Male
  • Patient Readmission / statistics & numerical data
  • Practice Guidelines as Topic*
  • Quality Indicators, Health Care / statistics & numerical data*