학술논문

Longitudinal trajectories of hospital performance across targeted cardiovascular conditions in the USA.
Document Type
article
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 6(1)
Subject
Clinical Research
Cardiovascular
Heart Disease - Coronary Heart Disease
Heart Disease
Health Services
Good Health and Well Being
Cardiovascular Diseases
Follow-Up Studies
Hospital Mortality
Hospitals
Humans
Patient Readmission
Retrospective Studies
United States
Heart failure
Hospital performance
Myocardial infarction
Quality
Language
Abstract
AimsThirty-day risk standardized readmission and mortality rates (RSRR, RSMR) are key determinants for hospital performance for cardiovascular conditions such as acute myocardial infarction (AMI) and heart failure (HF). We evaluated whether individual hospitals in the USA perform similarly for HF and AMI over time based on readmission and mortality metrics.Methods and resultsA total of 1950 hospitals in the USA with continuous participation in the Centers for Medicare and Medicaid Services (CMS) public reporting programme between 2010 and 2016 were identified. Latent mixture modelling was used to define performance trajectory groups. Overall, there were consistent declines in the RSMR (16.1-14.0%) and RSRR (20.3-16.6%) for AMI from 2010 to 2016. For HF, RSRR declined over time (25.1-21.7%), while there was a modest increase in RSMR (11.3-12.0%); parallel findings were observed across performance trajectory groups. The proportion of best performing centres for HF care that were also best performers for AMI care based on the 30-day RSMR and 30-day RSRR metric was 54% and 35%, respectively. Furthermore, the discordance rate between the best and worst performers for both conditions was low (