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Quality of care for patients with acute coronary syndromes as a function of hospital revascularization capability: Insights from get with the guidelines-CAD.

Publication ,  Journal Article
Thukkani, AK; Fonarow, GC; Cannon, CP; Cox, M; Hernandez, AF; Peterson, ED; Peacock, WF; Laskey, WK; Schwamm, LH; Bhatt, DL ...
Published in: Clin Cardiol
May 2014

BACKGROUND: Revascularization availability at US hospitals varies and may impact care quality for acute coronary syndrome patients. HYPOTHESIS: The hypothesis of this study was that there would be differences in care quality at Get With The Guidelines-Coronary Artery Disease (GWTG-CAD) hospitals based on revascularization capability. METHODS: For acute coronary syndrome patients admitted to GWTG-CAD hospitals between 2000 and 2010, care quality at hospitals with or without revascularization capability was examined by assessing conformity with performance and quality measures. RESULTS: This study included 95 999 acute coronary syndrome patients admitted to 310 GWTG-CAD hospitals. There were 89 000 patients admitted to 226 revascularization-capable hospitals and 6999 patients admitted to 84 hospitals without revascularization capability included. Adjusted multivariate analysis demonstrated that 8 of the 19 measures were more frequently performed in the revascularization cohort: aspirin (odds ratio [OR]: 1.41, 95% confidence interval [CI]: 1.04-1.92), clopidogrel (OR: 2.31, 95% CI: 1.78-3.00), lipid-lowering therapies at discharge (OR: 1.39, 95% CI: 1.04-1.87), lipid-lowering therapies for low-density lipoprotein >100 mg/dL (OR: 1.85, 95% CI: 1.23-2.77), achievement of blood pressure <140/90 mm Hg (OR: 1.20, 95% CI: 1.03-1.40), LDL recorded (OR: 1.47, 95% CI: 1.05-2.06), and recommendations offered for physical activity (OR: 3.82, 95% CI: 2.23-6.55) or weight management (OR: 1.74, 95% CI: 1.12-2.69). CONCLUSIONS: The GWTG-CAD revascularization hospitals were associated with better performance in some, but not all, measures assessed. Although the difference in conformity between hospital types was modest for performance measures but more variable for quality measures, room for improvement exists in key aspects of care.

Duke Scholars

Published In

Clin Cardiol

DOI

EISSN

1932-8737

Publication Date

May 2014

Volume

37

Issue

5

Start / End Page

285 / 292

Location

United States

Related Subject Headings

  • United States
  • Quality of Health Care
  • Prospective Studies
  • Practice Guidelines as Topic
  • Myocardial Revascularization
  • Middle Aged
  • Male
  • Humans
  • Hospitals
  • Guideline Adherence
 

Citation

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Thukkani, A. K., Fonarow, G. C., Cannon, C. P., Cox, M., Hernandez, A. F., Peterson, E. D., … Get With the Guidelines Steering Committee and Investigators, . (2014). Quality of care for patients with acute coronary syndromes as a function of hospital revascularization capability: Insights from get with the guidelines-CAD. Clin Cardiol, 37(5), 285–292. https://doi.org/10.1002/clc.22246
Thukkani, Arun K., Gregg C. Fonarow, Christopher P. Cannon, Margueritte Cox, Adrian F. Hernandez, Eric D. Peterson, W Frank Peacock, et al. “Quality of care for patients with acute coronary syndromes as a function of hospital revascularization capability: Insights from get with the guidelines-CAD.Clin Cardiol 37, no. 5 (May 2014): 285–92. https://doi.org/10.1002/clc.22246.
Thukkani AK, Fonarow GC, Cannon CP, Cox M, Hernandez AF, Peterson ED, et al. Quality of care for patients with acute coronary syndromes as a function of hospital revascularization capability: Insights from get with the guidelines-CAD. Clin Cardiol. 2014 May;37(5):285–92.
Thukkani, Arun K., et al. “Quality of care for patients with acute coronary syndromes as a function of hospital revascularization capability: Insights from get with the guidelines-CAD.Clin Cardiol, vol. 37, no. 5, May 2014, pp. 285–92. Pubmed, doi:10.1002/clc.22246.
Thukkani AK, Fonarow GC, Cannon CP, Cox M, Hernandez AF, Peterson ED, Peacock WF, Laskey WK, Schwamm LH, Bhatt DL, Get With the Guidelines Steering Committee and Investigators. Quality of care for patients with acute coronary syndromes as a function of hospital revascularization capability: Insights from get with the guidelines-CAD. Clin Cardiol. 2014 May;37(5):285–292.
Journal cover image

Published In

Clin Cardiol

DOI

EISSN

1932-8737

Publication Date

May 2014

Volume

37

Issue

5

Start / End Page

285 / 292

Location

United States

Related Subject Headings

  • United States
  • Quality of Health Care
  • Prospective Studies
  • Practice Guidelines as Topic
  • Myocardial Revascularization
  • Middle Aged
  • Male
  • Humans
  • Hospitals
  • Guideline Adherence