Hospitals Show Heart-Failure Treatment Gap

Study finds wide variance on 4 key indicators

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TUESDAY, July 12, 2005 (HealthDay News) -- The quality of care that heart-failure patients receive may depend largely on the hospital in which they receive that care, according to a new report based on hospitals' adherence to four standard measures of quality.

"This is one of the first studies to take a scientific look at the variation in performance measures in hospitals across the country," study lead author Dr. Gregg C. Fonarow, professor of cardiology at the University of California, Los Angeles, said in a prepared statement.

His team's findings appear in the July 11 issue of the journal Archives of Internal Medicine.

Fonarow and his colleagues analyzed heart-failure patient admissions data from 223 U.S. hospitals and compared how well the hospitals performed on four standard measures of heart failure treatment.

The four measures were:

  • Supplying the patient or caregiver with written instructions and guidance on post-discharge care. Only 24 percent of patients received complete discharge instructions, the researchers noted.
  • Adequate assessment of function in the heart's left ventricle -- the area of the heart that's most compromised in heart failure. The study found that 86.2 percent of the patients underwent a heart function assessment.
  • Prescription of an angiotensin-converting enzyme (ACE) inhibitor drug upon discharge in appropriate patients. This therapy has been found to be one of the most effective in prolonging life and reducing the risk of re-hospitalization. The study found that just 72 percent of eligible patients were prescribed ACE inhibitors.
  • Counseling on smoking cessation for appropriate patients. Only 43.2 percent of heart-failure patients who were current or recent smokers were offered this counseling.

"Gaps in care were seen in hospitals large and small, teaching and non-teaching, and all regions of the country. There is a definite opportunity for hospitals to improve in all these quality areas, especially since performance of these measures is closely linked to heart-failure patients' risk of rehospitalization and death," Fonarow said.

More information

The American Heart Association has more about heart failure.

SOURCE: University of California, Los Angeles, news release, July 11, 2005

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