Am
Heart J 1998 Feb;135(2 Pt 1):349-56
Resource use and quality of care for Medicare patients with acute myocardial
infarction in Maryland and the District of Columbia: analysis of data from
the Cooperative Cardiovascular Project.
Berger AK, Edris DW, Breall JA, Oetgen WJ, Marciniak TA, Molinari GF.
Institute for Cardiovascular Sciences, Department of Medicine, Georgetown
University Medical Center, Washington, DC 20007, USA.
This study sought to evaluate the quality of care rendered to Medicare
beneficiaries with acute myocardial infarction by establishing the use
patterns of well-proven therapies in this population. We analyzed the
quality of care rendered to 4300 Medicare beneficiaries seen at Maryland
and District of Columbia hospitals with retrospectively confirmed acute
myocardial infarction by evaluating the use of proven therapies. The proportion
of patients ideal for therapies ranged from 10% for reperfusion to 100%
for smoking cessation counseling. For ideal patients the following therapies
were implemented: aspirin (87%), reperfusion therapy (64%), beta-blockers
on discharge (60%), and smoking cessation counseling (41%). A substantial
proportion of Medicare patients with acute myocardial infarction has one
or more relative or absolute contraindications to standard regimens and
therefore are not ideal therapeutic candidates. In the group of ideal
patients, those with no therapeutic contraindications, a significant proportion
do not receive these
treatments.
PMID: 9489987 [PubMed - indexed for MEDLINE]
