Cardiac Performance Measure Compliance in Outpatients
Cardiac Performance Measure Compliance in Outpatients
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DOI：
10.1016/j.jacc.2010.03.043
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发表时间：
2010-06-29
影响因子：
24
通讯作者：
Spertus, John A.
中科院分区：
文献类型：
--
作者：
Chan, Paul S.;Oetgen, William J.;Spertus, John A.
目的：我们检查了2008年7月至2009年6月美国心脏病学会PINNACLE招募的14，464例患者的依从性（Practice Innovation And Clinical Excellence）计划，以提供对门诊心脏护理质量的初步见解。背景对患有冠状动脉疾病（CAD）、心力衰竭、和心房颤动，以及是否存在性别和种族差异的治疗门诊patients.Methods的PINNACLE计划是第一个，国家，前瞻性的办公室为基础的心脏病患者的质量改进计划的设计，在一定程度上，捕捉，报告，并提高门诊性能措施的遵守。我们检查了符合美国心脏病学会、美国心脏协会和美国医学会-医师绩效改善联盟（ACC/AHA/PCPI）对CAD、心力衰竭和房颤的绩效指标的患者比例。S.实践，占18，021次临床就诊。其中，8，132例（56.4%）患有CAD，5，012例（34.7%）患有心力衰竭，2，786例（19.3%）患有非瓣膜性房颤。从PINNACLE计划的数据收集24 25 ACC/AHA/PCPI性能指标是可行的。对业绩计量的遵守情况从很低（e.例如，在一个实施例中，13.3%的CAD患者筛查糖尿病）至非常高（e.例如，在一个实施例中，96.7%的心力衰竭患者进行了血压评估），大多数性能指标的依从性为中度（70%至90%）。对于3个性能指标，有小的差异，在遵守率的种族或sex.Conclusions为超过14,000例患者参加了27个实践中的门诊PINNACLE程序，我们发现，遵守性能指标是可变的，即使在考虑排除标准，这表明一个重要的机会，以提高门诊护理质量。（J Am科尔心脏病学杂志2010;56：8-14）（C）美国心脏病学会基金会2010年
Objectives We examined compliance with performance measures for 14,464 patients enrolled from July 2008 through June 2009 into the American College of Cardiology's PINNACLE (Practice Innovation And Clinical Excellence) program to provide initial insights into the quality of outpatient cardiac care.Background Little is known about the quality of care of outpatients with coronary artery disease (CAD), heart failure, and atrial fibrillation, and whether sex and racial disparities exist in the treatment of outpatients.Methods The PINNACLE program is the first, national, prospective office-based quality improvement program of cardiac patients designed, in part, to capture, report, and improve outpatient performance measure compliance. We examined the proportion of patients whose care was compliant with established American College of Cardiology, American Heart Association, and American Medical Association-Physician Consortium for Performance Improvement (ACC/AHA/PCPI) performance measures for CAD, heart failure, and atrial fibrillation.Results There were 14,464 unique patients enrolled from 27 U. S. practices, accounting for 18,021 clinical visits. Of these, 8,132 (56.4%) had CAD, 5,012 (34.7%) had heart failure, and 2,786 (19.3%) had nonvalvular atrial fibrillation. Data from the PINNACLE program were feasibly collected for 24 of 25 ACC/AHA/PCPI performance measures. Compliance with performance measures ranged from being very low (e. g., 13.3% of CAD patients screened for diabetes mellitus) to very high (e. g., 96.7% of heart failure patients with blood pressure assessments), with moderate (70% to 90%) compliance observed for most performance measures. For 3 performance measures, there were small differences in compliance rates by race or sex.Conclusions For more than 14,000 patients enrolled from 27 practices in the outpatient PINNACLE program, we found that compliance with performance measures was variable, even after accounting for exclusion criteria, suggesting an important opportunity to improve the quality of outpatient care. (J Am Coll Cardiol 2010;56:8-14) (C) 2010 by the American College of Cardiology Foundation