Opportunities and Challenges of Claims-Based Quality Assessment: The Case of Postdischarge β-Blocker Treatment in Patients With Heart Failure With Reduced Ejection Fraction.

Circulation. Cardiovascular Quality and Outcomes
Lauren GilstrapAndrea M Austin

Abstract

To combat the high cost and increasing burden of quality reporting, the Medicare Payment Advisory (MedPAC) has recommended using claims data wherever possible to measure clinical quality. In this article, we use a cohort of Medicare beneficiaries with heart failure with reduced ejection fraction and existing quality metrics to explore the impact of changes in quality metric methodology on measured quality performance, the association with patient outcomes, and hospital rankings. We used 100% Medicare Parts A and B and a random 40% sample of Part D from 2008 to 2015 to create (1) a cohort of 295 494 fee-for-service beneficiaries with ≥1 hospitalization for heart failure with reduced ejection fraction and (2) a cohort of 1079 hospitals with ≥11 heart failure with reduced ejection fraction admissions in 2014 and 2015. We used Part D data to calculate β-blocker use after discharge and β-blocker use over time. We then varied the quality metric methodologies to explore the impact on measured performance. We then used multivariable time-to-event analyses to explore the impact of metric methodology on the association between quality performance and patient outcomes and Kendall's Tau to describe impact of quality metric methodology on h...Continue Reading

References

Mar 16, 2007·Health Services Research·Joseph S Ross, Albert L Siu
Jan 13, 2009·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Bret A NicksMichael T Fitch
Mar 17, 2010·BMJ : British Medical Journal·Linda E LévesqueSamy Suissa
May 25, 2011·Pharmacoepidemiology and Drug Safety·Qian LiSoko Setoguchi
Apr 26, 2013·Circulation. Heart Failure·Paul A HeidenreichUNKNOWN Stroke Council
Jun 7, 2013·Circulation·UNKNOWN WRITING COMMITTEE MEMBERSUNKNOWN American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines
Mar 10, 2016·Health Affairs·Lawrence P CasalinoTodd B Evenson
Dec 27, 2016·Journal of the American College of Radiology : JACR·Andrew B RosenkrantzJoshua A Hirsch
Feb 9, 2017·PloS One·Johanna BirkhäuerHeike Gerger
Jul 16, 2019·JACC. Heart Failure·Alvin ChandraUNKNOWN PARAGON-HF Investigators
Aug 12, 2019·JACC. Heart Failure·Paul A Heidenreich

❮ Previous
Next ❯

Citations

Mar 10, 2020·Circulation. Cardiovascular Quality and Outcomes·Paul A Heidenreich

❮ Previous
Next ❯

Methods Mentioned

BETA
Destination

Software Mentioned

SAS

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.