Implication of performance measures for patients with heart failure: A Review
Abstract:
The strain of heart failure (HF) has become one of the cardinal public health complication, with constantly higher rates of serious morbidity and mortality. The American College of Cardiology (ACC) /American Heart Association (AHA) and the European Society of Cardiology (ESC) have developed evidence-based guidelines for the treatment of heart failure (HF) to help practitioners to ensure appropriate and consistent treatment for patients and improved clinical outcome. Performance measures are standards of care that imply that physicians are in error if they do not properly care for patients according to these standards and definitive diagnostic or therapeutic
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Performance measures are developed in different nation both in government and private organization following their own standard. These are also being used and publicly reported by governmental agencies such as the Centers for Medicare & Medicaid Services (CMS) and joint commission accreditation organizations such as JCAHO, as well as major insurers, and are often the criteria of pay-for performance demonstration projects. Mostly common measures for heart failure are ACEI or ARB, β-blocker, LV assessment and discharge instruction. Patient self care education, Telemonitoring /home based service counseling about ICD/CRT implantation for patients community heart failure services, anticoagulation or anti platelet drugs and smoking cessation counseling are also giving more importance now a day. The application of performance measures is not a unique method, characteristics of patients, quality of care, socio-economic, hospital-specific factors and collective measures are also important for …show more content…
After one year overall mortality and re-hospitalization rates were found 6.2% and 37.4%, respectively. A significant difference in event-free survival rate of mortality (94.7% vs. 89.8%, p = 0.003) and re-hospitalization (62.3% vs. 56.4%, p = 0.041) between the good and poor guideline-adherence groups were seen during Survival analysis by log-rank test