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Hospital Ratings Do Not Always Indicate Patient Outcomes

Quality measures do not reflect myocardial infarction mortality rates

WEDNESDAY, July 5 (HealthDay News) -- Hospitals' reported quality process measures for acute myocardial infarction are not always indicative of patient outcomes, according to a study published in the July 5 issue of the Journal of the American Medical Association.

Harlan M. Krumholz, M.D., S.M., of Yale University School of Medicine in New Haven, Conn., and colleagues assessed the performance of 962 hospitals that were participants in the National Registry of Myocardial Infarction, and used Medicare claims data to calculate each hospital's 30-day mortality rates.

Process measures such as β-blocker and aspirin use at admission and discharge, and use of angiotensin-converting enzyme inhibitors were strongly correlated with each other, and these medication measures were weakly associated with measures of smoking cessation counseling and time to reperfusion. Although some measures were strongly correlated with mortality rates, in sum they accounted for only 6 percent of hospital-level variations in mortality rates among acute myocardial infarction patients.

"The publicly reported acute myocardial infarction process measures capture a small proportion of the variation in hospitals' risk-standardized short-term mortality rates. Multiple measures that reflect a variety of processes and also outcomes, such as risk-standardized mortality rates, are needed to more fully characterize hospital performance," the authors conclude.

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