Quality of Care for Medicare Patients With Acute Myocardial Infarction

摘要: Objective. —To develop and test indicators of the quality care for patients with acute myocardial infarction (AMI). Design. —Retrospective medical record review. Setting. —All hospitals in Alabama, Connecticut, Iowa, Wisconsin. Patients. hospitalizations Medicare discharged a principal diagnosis AMI between June 1, 1992, February 28, 1993, were identified (N=16 869). Main Outcome Measure. —Percentage receiving appropriate interventions as defined by 11 quality-of-care derived from clinical practice guidelines that modified updated consultation national group physicians other health professionals. Results. —We abstracted data 16124 (96%) hospitalizations, representing 14 108 primary 2016 resulting transfers. Potential exclusions to use standard treatments common 90% 70% having potential thrombolytics β-blockers, respectively. In cohorts "ideal candidates" specific interventions, 83% received aspirin, 69% thrombolytics, heparin during initial hospitalization; 77% aspirin 45% β-blockers at discharge. Conclusions. —These demonstrate many may not be ideal candidates therapies, but these are under-used, even absence discernible contraindications. Hospitals who apply their practices likely find opportunities improvement. (JAMA. 1995;273:1509-1514)