Academic researchers reported that all five standard hospital-based performance measures used to gauge quality of care for hospitalized heart failure patients may not be the best benchmarks since none were significant predictors of patient mortality during the critical first 60 to 90 days immediately following hospital discharge.
Published in the Jan. 3 issue of the Journal of the American Medical Association, the study found that none of the current measures used by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) which accredits hospitals and by the Federal Government through the Center for Medicare and Medicaid Services (CMS) to assess hospital performance were associated with a lower risk of mortality during the days immediately following hospital discharge when adverse events are most likely to occur.
Only one of the standard measures modestly influenced mortality and rehospitalization rates. Researchers also reported that use of beta blocker medications in eligible heart failure patients at time of hospital discharge, currently not a JCAHO/CMS performance measure, was associated with the most significant improvements in heart failure patient outcomes predictive of a 52 percent reduction in mortality during the first 60 to 90 day period after hospital discharge.
Professional societies, health care accrediting organizations, the government, and major insurers use performance measures to rank and accredit hospitals, rate quality of care, and develop hospital as well as physician pay-for- performance initiatives. According to researchers, performance measures should reflect the strongest clinical evidence in practice and failure to perform these key treatments should reduce the likelihood of optimal patient outcomes.
"The study's findings are quite surprising since it has been commonly held that existing performance measures could be used to distinguish hospitals that provide higher quality heart
Contact: Rachel Champeau
University of California - Los Angeles