Abstract:
BACKGROUND:Quality indicators for Chinese patients with chronic heart failure (CHF) have been developed. However, little is known about the compliance with quality indicators and the association between process indicators and in-hospital mortality in China. METHODS:Data from 1862 CHF admissions between 1 January 2009 and 31 October 2010 at 20 tertiary hospitals in Heilongjiang Province were analyzed. Hierarchical generalized linear models were used to examine the association between six process indicators and in-hospital mortality in eligible patients. RESULTS:The in-hospital mortality for the 1862 patients was 4.7%. The compliance with six process indicators were: evaluation of left ventricular function, 66.4%; angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB), 54.9%; diuretic, 86.2%; beta-blocker, 45.1%; aldosterone-receptor antagonist, 64.0%; and warfarin, 17.1%. Rates of compliance at the hospital level varied from 0 to 100%. After the adjustment for confounding factors, evaluation of left ventricular function, ACEI/ARB and aldosterone receptor antagonist were significantly associated with in-hospital mortality ([OR, 0.55; 95% CI, 0.33-0.93; P = 0.027], [OR, 0.33; 95% CI, 0.12-0.94; P = 0.040] and [OR, 0.35; 95% CI, 0.13-0.98; P = 0.046], respectively). CONCLUSIONS:There are considerable gaps between guidelines and clinical practice and variations across hospitals for the treatment of patients with CHF. Evaluation of left ventricular function, ACEI/ARB and aldosterone receptor antagonist will reduce the risk of in-hospital mortality. The association of other process indicators with clinical outcomes remain to be established.
journal_name
Eur J Public Healthjournal_title
European journal of public healthauthors
Fu R,Xiang J,Bao H,Wang Z,Wang Y,Chen Y,Zhang H,Liu D,Liu Mdoi
10.1093/eurpub/cku187subject
Has Abstractpub_date
2015-06-01 00:00:00pages
373-8issue
3eissn
1101-1262issn
1464-360Xpii
cku187journal_volume
25pub_type
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