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Effect of compliance with quality performance measures for heart failure on clinical outcomes in high-risk patients

Ishak A Mansi1, Runhua Shi, Mehreen Khan

  • 1Internal Medicine Service, Brooke Army Medical Center, 3851 Roger Brooke Dr., San Antonio, TX 78234-6200, USA. ishak.mansi@us.army.mil

Journal of the National Medical Association
|November 9, 2010
PubMed

Insights

Compliance with The Joint Commission (TJC) quality measures for heart failure in high-risk populations was linked to increased patient readmissions. This suggests a potential disconnect between national benchmarks and patient-centered care outcomes.

Area of Science:

  • Health Services Research
  • Quality Improvement in Healthcare
  • Cardiology Outcomes

Background:

  • Limited data exists on the impact of The Joint Commission (TJC) performance measures on patient outcomes within specialized, high-risk healthcare settings.
  • Previous research has focused on national trends, overlooking site-specific effects of quality metrics.

Purpose of the Study:

  • To evaluate the association between adherence to TJC core quality measures for heart failure and patient outcomes.
  • The study focused on a university hospital serving a high-risk, indigent patient population.

Main Methods:

  • Retrospective review of heart failure patient records at a Louisiana university hospital.
  • Patients were categorized into quality-compliant and quality-deficient groups based on TJC measures.
  • Multivariate regression analyses assessed heart failure admission rates and 90-day readmissions.

Main Results:

  • The quality-compliant group exhibited higher annual heart failure admission rates.
  • Patients in the quality-compliant group had significantly higher 90-day readmission rates (OR, 2.82; P = .02).

Conclusions:

  • Adherence to TJC heart failure quality measures at this academic medical center correlated with increased patient readmissions.
  • Potential contributing factors include patient characteristics and an emphasis on national reporting over patient-centered care.
Abstract

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