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Commentary | Clinician's Corner

Heart Failure Performance Measures and Outcomes:  Real or Illusory Gains

Gregg C. Fonarow, MD; Eric D. Peterson, MD, MPH
JAMA. 2009;302(7):792-794. doi:10.1001/jama.2009.1180.
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Heart failure is one of the most deadly and costly conditions in the United States.1 Among Medicare beneficiaries, heart failure is the most frequent cause of hospitalization and death, with 1-year readmission and mortality rates of 65% and 35%, respectively.2 While a number of therapies and interventions have been demonstrated to improve heart failure outcomes,1 studies have consistently shown gaps, variations, and disparities in the application of these therapies in routine clinical practice.3

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Figure. Temporal Trends in Process Measures and Clinical Outcomes for Medicare Patients Hospitalized With Heart Failure, 2002-2007
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Source population for process measures comprised patients hospitalized at Joint Commission–accredited hospitals; source population for rehospitalization and mortality outcomes comprised Medicare beneficiaries 65 years or older; outcomes data for 2007 are not yet available. Beginning in 2005, the data collection method changed from the abstraction of randomly selected medical records for Medicare beneficiaries to the receipt of hospital self-reported data for all payer types. LV indicates left ventricular. Data from Curtis et al2 and The Joint Commission 2008 quality report.6




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