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The Cooperative Cardiovascular Project in Oklahoma

D W Bratzler1, A C de Leon, M C Johnson

  • 1Oklahoma Foundation for Medical Quality, Inc., Oklahoma City 73118-9984, USA.

The Journal of the Oklahoma State Medical Association
|July 1, 1997
PubMed
Summary

Potentially life-saving treatments for acute myocardial infarction are underused in Medicare patients. Quality improvement efforts are needed to ensure optimal care for beneficiaries hospitalized with heart attacks.

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Area of Science:

  • Cardiology
  • Health Services Research
  • Quality Improvement

Background:

  • Acute myocardial infarction (AMI) is a leading cause of death in the US.
  • AMI is a common reason for hospitalization among Oklahoma Medicare beneficiaries.
  • The Cooperative Cardiovascular Project aimed to assess AMI care quality for Medicare patients.

Purpose of the Study:

  • To evaluate the quality of care for Medicare beneficiaries hospitalized with acute myocardial infarction.
  • To identify performance measures for AMI management based on established guidelines.
  • To support hospital-based quality improvement initiatives for AMI care.

Main Methods:

  • Retrospective review of inpatient medical records.
  • Analysis of 3,436 patients from 102 Oklahoma hospitals.

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  • Inclusion of a national random sample of 2,441 AMI patients.

    • Main Results:

    • Diagnosis of AMI confirmed in 89% of reviewed cases.
    • Reperfusion therapy used in 62% of ideal candidates; aspirin in 84% during hospitalization and 76% at discharge.
    • Beta-blocker use at discharge was 40%; significant inter-hospital variations noted for key treatments and counseling.

    Conclusions:

    • Underutilization of potentially life-saving treatments for hospitalized Medicare patients with AMI.
    • Improving the quality of care for Medicare beneficiaries with AMI is a national health priority.