title: Comparison of performance on Hospital Compare process measures and patient outcomes between hospitals that do and do not participate in Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines.
abstract: BACKGROUND
  Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines (ACTION Registry-GWTG) was designed to measure and improve the treatment and outcomes of patients with acute myocardial infarction (AMI), yet it is unknown whether performance of Medicare Hospital Compare metrics and outcomes differ between hospitals participating versus those not participating in the registry.
  
  
  METHODS
  Using 2007 to 2010 Hospital Compare data, we matched participating to nonparticipating hospitals based on teaching status, size, percutaneous coronary intervention capability, and baseline (2007) Hospital Compare AMI process measure performance. We used linear mixed modeling to compare 2010 Hospital Compare process measure adherence, 30-day risk-adjusted mortality, and readmission rates. We repeated these analyses after stratification according to baseline performance level.
  
  
  RESULTS
  Compared with nonparticipating hospitals, those participating were larger (median 288 vs 139 beds, P < .0001), more often teaching hospitals (18.8% vs 6.3%, P < .0001), and more likely had interventional catheterization lab capabilities (85.7% vs 34.0%, P < .0001). Among 502 matched pairs of participating and nonparticipating hospitals, we found high levels of process measure adherence in both 2007 and 2010, with minimal differences between them. Rates of 30-day mortality and readmission in 2010 were also similar between both groups. Results were consistent across strata of baseline performance level.
  
  
  CONCLUSIONS
  In this observational analysis, there were no significant differences in the performance of Hospital Compare process measures or outcomes between hospitals in Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines and other hospitals not in the registry. However, baseline performance on the Hospital Compare process measures was very high in both groups, suggesting the need for new quality improvement foci to further improve patient outcomes.
authors.affiliation: Duke Clinical Research Institute/Duke University Medical Center, Durham, NC. Electronic address: robin.mathews@duke.edu.
authors.forename: Robin
authors.initials: R
authors.lastname: Mathews
authors.affiliation: Ahmanson-UCLA Cardiomyopathy Center, University of California Los Angeles, Los Angeles, CA.
authors.forename: Gregg C
authors.initials: GC
authors.lastname: Fonarow
authors.affiliation: Duke Clinical Research Institute/Duke University Medical Center, Durham, NC.
authors.forename: Shuang
authors.initials: S
authors.lastname: Li
authors.affiliation: Duke Clinical Research Institute/Duke University Medical Center, Durham, NC.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Peterson
authors.affiliation: Denver VA Medical Center, Denver, CO.
authors.forename: John S
authors.initials: JS
authors.lastname: Rumsfeld
authors.affiliation: VA Palo Alto Health System, Palo Alto, CA.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Heidenreich
authors.affiliation: Duke Clinical Research Institute/Duke University Medical Center, Durham, NC.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Roe
authors.affiliation: American College of Cardiology, Washington, DC.
authors.forename: William J
authors.initials: WJ
authors.lastname: Oetgen
authors.affiliation: Duke Clinical Research Institute/Duke University Medical Center, Durham, NC.
authors.forename: James G
authors.initials: JG
authors.lastname: Jollis
authors.affiliation: Brigham and Women's Hospital, Boston, MA.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Cannon
authors.affiliation: University of Texas-Southwestern Medical Center, Dallas, TX.
authors.forename: James A
authors.initials: JA
authors.lastname: de Lemos
authors.affiliation: Duke Clinical Research Institute/Duke University Medical Center, Durham, NC.
authors.forename: Tracy Y
authors.initials: TY
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D019468:Disease Management; D005260:Female; D019983:Guideline Adherence; D006761:Hospitals / Q000145:classification / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy; D010043:Outcome and Process Assessment, Health Care; D062645:Percutaneous Coronary Intervention / Q000379:methods / Q000706:statistics & numerical data; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data; D012042:Registries; D014481:United States / Q000453:epidemiology
chemical_list: D002317:Cardiovascular Agents