title: Chest pain center accreditation is associated with better performance of centers for Medicare and Medicaid services core measures for acute myocardial infarction.
abstract: The aim of this study was determine whether hospitals accredited by the Society of Chest Pain Centers hospitals (accredited chest pain centers [ACPCs]) are associated with better performance regarding Centers for Medicare and Medicaid Services core measures for acute myocardial infarction (AMI) than nonaccredited hospitals. The study was a retrospective, observational cohort study of hospitals reporting Centers for Medicare and Medicaid Services core measures for AMI from January 1, 2005, to December 31, 2005, on the basis of the presence or absence of Society of Chest Pain Centers accreditation. Data were obtained from the Web sites of the Centers for Medicare and Medicaid Services (Hospital Compare), Society of Chest Pain Centers listings, and the American Hospital Directory. Groups were compared in terms of demographics and mean percentage compliance with all 8 AMI core measures. Student's t test, chi-square analysis, and logistic regression were used to analyze bivariate relations. Multivariate logistic regression models used a propensity-score adjustment factor. Of the 4,197 hospitals that reported core measures for AMI, 178 (4%) were accredited and 4,019 (96%) were not. ACPCs had been accredited for an average of 12 months and were larger (378 vs 204 beds), more often teaching hospitals (52% vs 30%), and more often urban (95% vs 69%) (all p <0.0001). There were 395,250 patients with AMIs, of whom 55,418 (14%) presented to ACPCs and 339,832 (86%) presented to nonaccredited hospitals. There was significantly greater compliance with all 8 AMI core measures at ACPCs (p <0.0001), except for lytic therapy <30 minutes after arrival (p = 0.04), for which unadjusted performance was the same. In conclusion, ACPCs were associated with better compliance with Centers for Medicare and Medicaid Services core measures and saw a greater proportion of patients with AMIs.
authors.affiliation: Emory University School of Medicine, Atlanta, Georgia, USA. michael.ross@emoryhealthcare.org
authors.forename: Michael A
authors.initials: MA
authors.lastname: Ross
authors.forename: Ezra
authors.initials: E
authors.lastname: Amsterdam
authors.forename: W Frank
authors.initials: WF
authors.lastname: Peacock
authors.forename: Louis
authors.initials: L
authors.lastname: Graff
authors.forename: Francis
authors.initials: F
authors.lastname: Fesmire
authors.forename: J Lee
authors.initials: JL
authors.lastname: Garvey
authors.forename: Sue
authors.initials: S
authors.lastname: Kelly
authors.forename: Kay
authors.initials: K
authors.lastname: Holmes
authors.forename: H B
authors.initials: HB
authors.lastname: Karunaratne
authors.forename: Margaret
authors.initials: M
authors.lastname: Toth
authors.forename: Shahriar
authors.initials: S
authors.lastname: Dadkhah
authors.forename: James
authors.initials: J
authors.lastname: McCord
mesh_terms: D000068:Accreditation; D019985:Benchmarking; D002300:Cardiac Care Facilities / Q000592:standards*; D014487:Centers for Medicare and Medicaid Services, U.S.; D002637:Chest Pain; D006801:Humans; D016015:Logistic Models; D008484:Medicaid; D006278:Medicare; D015233:Models, Statistical; D009203:Myocardial Infarction / Q000175:diagnosis / Q000628:therapy; D011787:Quality of Health Care; D012189:Retrospective Studies; D014481:United States