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Generalizability and longitudinal outcomes of a national heart failure clinical registry: Comparison of Acute Decompensated Heart Failure National Registry (ADHERE) and non-ADHERE Medicare beneficiaries.

Publication ,  Journal Article
Kociol, RD; Hammill, BG; Fonarow, GC; Klaskala, W; Mills, RM; Hernandez, AF; Curtis, LH
Published in: Am Heart J
November 2010

BACKGROUND: Clinical registries are used increasingly to analyze quality and outcomes, but the generalizability of findings from registries is unclear. METHODS: We linked data from the Acute Decompensated Heart Failure National Registry (ADHERE) to 100% fee-for-service Medicare claims data. We compared patient characteristics and inpatient mortality of linked and unlinked ADHERE hospitalizations; patient characteristics, readmission, and postdischarge mortality of linked ADHERE patients to a random 20% sample of Medicare beneficiaries hospitalized for heart failure; and characteristics of Medicare sites participating and not participating in ADHERE. RESULTS: Among 135,667 ADHERE records for eligible patients ≥ 65 years, we matched 104,808 (77.3%) records to fee-for-service Medicare claims, representing 82,074 patients. Linked hospitalizations were more likely than unlinked hospitalizations to involve women and white patients; there were no meaningful differences in other patient characteristics. In-hospital mortality was identical for linked and unlinked hospitalizations. In Medicare, ADHERE patients had slightly lower unadjusted mortality (4.4% vs 4.9% in-hospital, 11.2% vs 12.2% at 30 days, 36.0% vs 38.3% at 1 year [P < .001]) and all-cause readmission (22.1% vs 23.7% at 30 days, 65.8% vs 67.9% at 1 year [P < .001]). After risk adjustment, modest but statistically significant differences remained. ADHERE hospitals were more likely than non-ADHERE hospitals to be teaching hospitals, have higher volumes of heart failure discharges, and offer advanced cardiac services. CONCLUSION: Elderly patients in ADHERE are similar to Medicare beneficiaries hospitalized with heart failure. Differences related to selective enrollment in ADHERE hospitals and self-selection of participating hospitals are modest.

Duke Scholars

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Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

November 2010

Volume

160

Issue

5

Start / End Page

885 / 892

Location

United States

Related Subject Headings

  • United States
  • Retrospective Studies
  • Registries
  • Quality of Health Care
  • Medicare
  • Male
  • Humans
  • Hospitalization
  • Hospital Mortality
  • Heart Failure
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kociol, R. D., Hammill, B. G., Fonarow, G. C., Klaskala, W., Mills, R. M., Hernandez, A. F., & Curtis, L. H. (2010). Generalizability and longitudinal outcomes of a national heart failure clinical registry: Comparison of Acute Decompensated Heart Failure National Registry (ADHERE) and non-ADHERE Medicare beneficiaries. Am Heart J, 160(5), 885–892. https://doi.org/10.1016/j.ahj.2010.07.020
Kociol, Robb D., Bradley G. Hammill, Gregg C. Fonarow, Winslow Klaskala, Roger M. Mills, Adrian F. Hernandez, and Lesley H. Curtis. “Generalizability and longitudinal outcomes of a national heart failure clinical registry: Comparison of Acute Decompensated Heart Failure National Registry (ADHERE) and non-ADHERE Medicare beneficiaries.Am Heart J 160, no. 5 (November 2010): 885–92. https://doi.org/10.1016/j.ahj.2010.07.020.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

November 2010

Volume

160

Issue

5

Start / End Page

885 / 892

Location

United States

Related Subject Headings

  • United States
  • Retrospective Studies
  • Registries
  • Quality of Health Care
  • Medicare
  • Male
  • Humans
  • Hospitalization
  • Hospital Mortality
  • Heart Failure