[Assessment of quality of care in heart failure].
OBJECTIVE
To evaluate the presence of predetermined quality aspects in the management of hearth failure inside an Internal Medicine Department.


METHODS
Prospective study under protocol of 200 patients admitted to our Internal Medicine Department under diagnosis of hearth failure from july 97 to july 98.


RESULTS
Every patient of our study had an anamnesis, physical examination, chest radiology and electrocardiography. Only 42.4% had an electrocardiography. Hearth failure etiology was determined in only 62.6% (30% isquemic, 22% hypertensive, 6% mixed, 30% valvulopathy, 9% specific myocardiopathy, 3% others). 47.5% of the patients were functionally classified after NYHA (I 2.7%, II 58%, III 35.4%, IV 3.6%). Treatment and drug dosing were adequate in 85.5% (diuretics 91%, ACEI 42%, digitalis 36%, nitrates 56%, inotropic drugs 2%, betablockers and calcium antagonists 1%). 13% of the patients were admitted to the hospital more than three times a year. Mortality rate was 18% and 19% of them were older than 70 years old.


CONCLUSIONS
Quality management indicators were acceptably present in our study. We must insist on etiologic diagnosis and NYHA classification as a way of improving care.
Suárez Herranz
P
P
Servicio de Medicina Interna del Hospital General Universitario Gregorio Marañón, Madrid.
Gabarró López
N
N
Gil Gómez
J
J
Millán Núñez-Cortés
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011785:Quality Assurance, Health Care