title: Analysis of a large cohort of health maintenance organization patients with congestive heart failure.
abstract: The aim of this article was to measure guideline compliance in the care of health plan members diagnosed with congestive heart failure (CHF). Chart review was conducted on members with a discharge diagnosis of CHF (n = 2,697). Information was entered onto a scannable form designed by the health plan, which was coupled to an optical character recognition reader and entered into a database. Eighty-four percent of the patients had an ejection fraction (EF) measured. An angiotensin-converting enzyme inhibitor was prescribed to 72% of patients with an EF less than 40%. Comorbidities and other measures were evaluated and based on guideline recommendations. Most of the CHF patients in this health plan are being treated appropriately during posthospitalization for CHF. The use of a novel, cost-effective method for data collection resulted in the rapid acquisition of clinical data for analysis.
authors.affiliation: Quality Management Specialist, Highmark Blue Cross Blue Shield, Pittsburgh, PA 15222-3099, USA. patty.gladowski@highmark.com
authors.forename: Patricia
authors.initials: P
authors.lastname: Gladowski
authors.forename: Donald
authors.initials: D
authors.lastname: Fetterolf
authors.forename: Susan
authors.initials: S
authors.lastname: Beals
authors.forename: Mary Kay
authors.initials: MK
authors.lastname: Holleran
authors.forename: Sanford
authors.initials: S
authors.lastname: Reich
mesh_terms: D000328:Adult; D000572:American Heart Association; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D015331:Cohort Studies; D015897:Comorbidity; D000529:Complementary Therapies; D004232:Diuretics / Q000627:therapeutic use*; D005260:Female; D019983:Guideline Adherence; D006279:Health Maintenance Organizations / Q000592:standards*; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008485:Medical Audit; D020398:Medicare Part C; D008875:Middle Aged; D010414:Pennsylvania; D017410:Practice Guidelines as Topic
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics