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Editorials

Measuring Quality in Heart Failure

Do We Have the Metrics?

Robert O. Bonow, MD

From the Division of Cardiology, Northwestern University Feinberg School of Medicine, and the Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, Chicago, Ill.

Correspondence to Robert O. Bonow, MD, Division of Cardiology, Northwestern University Feinberg School of Medicine, 201 E Huron St, Suite 10–240, Chicago, IL 60611. E-mail r-bonow@northwestern.edu

Key Words: Editorials • heart failure • outcomes • quality

An extract of the first 250 words of the full text is provided, because this article has no abstract.

As we approach the end of the first decade of the 21st century, it is evident that the epidemic of heart failure has not abated, nor have concerns about the quality of care received by patients with this condition. Recent data from the American Heart Association¹ and the Centers for Disease Control and Prevention² reaffirm that the number of patients hospitalized with heart failure has grown steadily over the past 30 years. With aging of the US population, this trend will undoubtedly continue, but it is also noteworthy that the increase in heart failure hospitalizations over the past few decades is not limited to the Medicare population.² Moreover, the outcome of heart failure patients after hospital discharge is not improving. Despite evidence-based guidelines, performance measures, quality improvement programs, and public reporting of hospital-level performance data, the number of patients dying or readmitted to hospitals within 30 days of hospital discharge has not declined^3–6 and is equivalent in patients with depressed and those with preserved left ventricular systolic function.⁷ Hospital readmission is expensive and contributes to the increasing economic burden of heart failure, but this is often a preventable event. However, the characteristics of patients who will require rehospitalization have not been identified,⁵ and it is impossible to predict which patients will be readmitted. In many cases it is not the patient, but the healthcare system involving multiple providers and transitions of care, that makes the conditions ripe for high readmission rates.

Article See p 29

The fundamental first step in . . . [Full Text of this Article]

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