Measuring performance for treating heart attacks and heart failure: the case for outcomes measurement.
To complement the current process measures for treating patients with heart attacks and with heart failure, which target gaps in quality but do not capture patient outcomes, the Centers for Medicare and Medicaid Services (CMS) has proposed the public reporting of hospital-level thirty-day mortality for these conditions in 2007. We present the case for including measurements of outcomes in the assessment of hospital performance, focusing on the care of patients with heart attacks and with heart failure. Recent developments in the methodology and standards for outcomes measurement have laid the groundwork for incorporating outcomes into performance monitoring efforts for these conditions.
Krumholz
Harlan M
HM
Yale University School of Medicine, New Haven, Connecticut, USA. harlan.krumholz@yale.edu
Normand
Sharon-Lise T
SL
Spertus
John A
JA
Shahian
David M
DM
Bradley
Elizabeth H
EH
D016507:Cardiology Service, Hospital / Q000592:standards*; D014487:Centers for Medicare and Medicaid Services, U.S.; D030881:Disclosure; D019983:Guideline Adherence; D006333:Heart Failure / Q000401:mortality / Q000628:therapy*; D006801:Humans; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care; D017410:Practice Guidelines as Topic; D019984:Quality Indicators, Health Care; D020379:Risk Adjustment; D014481:United States / Q000453:epidemiology