Correlates of outcomes in patients with congestive heart failure

This study relates components of care, including patient characteristics, degree of initial morbidity, and process of care, to patient outcomes. One hundred twenty-two adults who were being treated for congestive heart failure by a sample of physicians in Fort Wayne, Indiana were studied. Data were obtained on the patients' personal characteristics; degree of illness at the beginning of the six-month study period; process measures (physician awareness, communication, medication use, therapeutic management, patient satisfaction, and utilization of services); and level of activity and symptoms at the end of the study period. These components were quantified and subjected to correlation and regression analysis. The largest and most significant predictors of outcome status were measures of initial disease status. Process variables were strongly and significantly associated with outcome only in a group of patients who were minimally symptomatic initially. The lack of an overall association between process of medical care and patient outcome cannot be generalized beyond these patients with congestive heart failure. A similar approach of dissection, quantification, and analysis of components of care, however, can be used to explore a possible relationship in other conditions and care delivery settings.