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Hospital-Level Performance Improvement

Beta-Blocker Use After Acute Myocardial Infarction

Datos Bibliográficos

ID9102376
AutoresElizabeth H Bradley (0000-0003-2592-2741, Yale University, autor de correspondencia), Judith Herrin (0000-0002-3671-3622), Jeph Herrin, Jennifer A Mattera (0000-0001-8229-9939, Yale New Haven Hospital), Eric S Holmboe (0000-0003-0108-6021, Yale University), Yongfei Wang (0009-0000-3231-0749, Yale University), Paul Frederick (Ovation Fertility), Sarah A Roumanis (Yale New Haven Hospital), Martha J Radford (0000-0001-7503-9557, Yale University, autor de correspondencia), Harlan M Krumholz (0000-0003-2046-127X, Yale New Haven Hospital, autor de correspondencia)
Año2004
Volumen42
Número6
Páginas591-599
Fecha de publicación2004-06-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/01.mlr.0000128006.27364.a9
PMID15167327
OpenAlexW2009038072
IdiomaEN
Citas recibidas3
Referencias citadas28

BACKGROUND: National surveys indicate improvement in beta-blocker use after acute myocardial infarction (AMI) over time; however, these data could obscure important variation in improvement at individual hospitals. Our objective was to characterize the hospital-level variation in the improvements in beta-blocker prescription rates after AMI and to identify hospital characteristics that were associated with hospital improvement rates after adjustment for patient demographic and clinical characteristics. METHODS AND RESULTS: We used data (n = 335,244 patients with AMI discharged from 682 hospitals) from the National Registry of Myocardial Infarction (NRMI) and from the American Hospital Association Annual Survey of Hospitals and hierarchical modeling to examine the associations between hospital characteristics and hospital-level rates of change in beta-blocker use during 1996-1999. On average, hospital rates of beta-blocker use for patients with AMI increased 5.9 percentage points (standard deviation, 9.7 percentage points) from the premidpoint time period (April 1996-February 1998) to the postmidpoint time period (March 1998-September 1999) of the study. The range in hospital-level changes in beta-blocker rates was substantial, from a decline of -50.0 percentage points to an increase of +35.7 percentage points. AMI volume and teaching status, geographic region, and initial beta-blocker use rates were associated with rate of improvement, but the magnitude of these effects was modest. CONCLUSIONS: The study reveals marked hospital-level variation in improvement in beta-blocker use after AMI. Several hospital characteristics were associated with this improvement, but they are weak predictors of hospital-based improvement in the use of beta-blockers

Beta blocker · Heart failure · Hospital readmission · Medical prescription · Myocardial infarction · Acute Myocardial Infarction Research · Emergency Medicine · Heart Failure Treatment and Management · Internal Medicine · Medicine · Sepsis Diagnosis and Treatment

  • Quality Improvement Efforts and Hospital Performance

    Elizabeth H Bradley, Judith Herrin et al.•Medical Care•2005

  • Hospital Variation in Mortality After First Acute Myocardial Infarction in Denmark From 1995 to 2002

    Soren Rasmussen, Ann-Dorthe O Zwisler et al.•Medical Care•2005

  • Hospital Variation in Use of Secondary Preventive Medicine After Discharge for First Acute Myocardial Infarction During 1995–2004

    Soren Rasmussen, Steen Z Abildstrom et al.•Medical Care•2008

  • The Quality of Health Care Delivered to Adults in the United States

    ELIZABETH A MCGLYNN, Steven M Asch et al.•New England Journal of Medicine•2003

  • Is Volume Related to Outcome in Health Care? A Systematic Review and Methodologic Critique of the Literature

    Open Access•Ethan A Halm, Clara Lee et al.•Annals of Internal Medicine•2002

  • Association of Physician and Hospital Volume With Use of Aspirin and Reperfusion Therapy in Acute Myocardial Infarction

    Donald J Willison, Stephen B Soumerai et al.•Medical Care•2000

Obras citantes distintas3
Citas por año0,14
Intervalo de citas2005 - 2008 (4)
Velocidad de citaciónhistorical
Altamente citadoNo
Tipos de citaNeutras: 3
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