title: Heart failure performance measures: do they have an impact on 30-day readmission rates?
abstract: Congestive heart failure (CHF) accounts for more health care costs than any other diagnosis. Readmissions contribute to this expenditure. The authors evaluated the relationship between adherence to performance metrics and 30-day readmissions. This was a retrospective study of 6063 patients with CHF between 2001 and 2008. Data were collected for 30-day readmissions and compliance with CHF performance measures at discharge. Rates of readmission for CHF increased from 16.8% in 2002 to 24.8% in 2008. Adherence to performance measures increased concurrently from 95.8% to 99.9%. Except for left ventricular function (LVF) assessment, the 30-day readmission rate was not associated with adherence to performance measures. Readmitted patients had twice the odds of not having their LVF assessed (odds ratio = 2.0; P < .00005; 95% confidence interval = 1.45-2.63). CHF performance measures, except for the LVF assessment, have little relationship to 30-day readmissions. Further studies are needed to identify performance measures that correlate with quality of care.
authors.affiliation: Kettering Medical Center, Division of Cardiovascular Medicine, 3535 Southern Blvd, Kettering, OH 42429, USA. sulamazi@yahoo.com
authors.forename: Sula
authors.initials: S
authors.lastname: Mazimba
authors.forename: Nakash
authors.initials: N
authors.lastname: Grant
authors.forename: Analkumar
authors.initials: A
authors.lastname: Parikh
authors.forename: George
authors.initials: G
authors.lastname: Mwandia
authors.forename: Diklar
authors.initials: D
authors.lastname: Makola
authors.forename: Christine
authors.initials: C
authors.lastname: Chilomo
authors.forename: Cristina
authors.initials: C
authors.lastname: Redko
authors.forename: Harvey S
authors.initials: HS
authors.lastname: Hahn
mesh_terms: D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D059019:Clinical Coding; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D006801:Humans; D016014:Linear Models; D008297:Male; D009096:Multi-Institutional Systems; D005791:Patient Care / Q000592:standards*; D010351:Patient Discharge / Q000706:statistics & numerical data / Q000639:trends; D010353:Patient Education as Topic; D010359:Patient Readmission / Q000706:statistics & numerical data* / Q000639:trends; D019984:Quality Indicators, Health Care; D012189:Retrospective Studies; D016540:Smoking Cessation / Q000706:statistics & numerical data; D016277:Ventricular Function, Left
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors
keywords: CHF; core measures; quality; readmissions