Risk-standardized cardiovascular mortality rates vary substantially for ischemic heart disease (IHD) and chronic heart failure (CHF) across the Department of Veterans Affairs medical centers (VAMCs), according to a study published online May 16 in JAMA Cardiology.
Researchers, led by Peter W. Groeneveld, MD, of the University of Pennsylvania School of Medicine, found mortality rates varied across VAMCs from 5.5 to 9.4 percent for IHD and 11.1 to 18.9 percent for CHF.
“IHD and CHF are highly prevalent in the Veterans Affairs (VA) healthcare system, and mortality is high for both conditions,” wrote Groeneveld and colleagues. “For more than 20 years, the VA has attempted to measure and improve healthcare quality for veterans with these conditions,yet most of these efforts have focused on either process measures of quality or surrogate clinical outcomes. Very limited data are available on clinical outcomes, and many of these outcome measures are restricted to patients hospitalized with acute cardiovascular events such as myocardial infarction or CHF exacerbations.”
Groeneveld and colleagues sought to determine if mortality rates differed across VAMCs for patients receiving treatment for IHD and CHF.
They reviewed the annual risk-standardized mortality rates among more than 930,000 veterans with ischemic heart disease and more than 348,000 veterans with chronic heart failure who received care at 130 VAMCs over a four-year period.
The researchers noted the differences in mortality rates among VA chronic cardiovascular disease (CVD) populations may reflect varying quality of care for CVD-related conditions. Variables include clinician adherence to evidence-based treatment and screening guidelines, access to care for urgent medical conditions, posthospitalization care protocols, chronic disease management programs and access to specialty care, social work services and behavioral healthcare.
“Our findings may be placed in the context of increasing emphasis on the importance of hospital/health system quality performance in the care of populations of patients with chronic disease,” Groeneveld et al. said. “While hospital outcomes for the treatment of acute medical episodes, such as myocardial infarction, remains an important quality measure, mortality rates among the broader population of patients receiving care by a hospital and/or its outpatient clinics provides important insight into the effectiveness of the hospital/health system in optimizing the health of its patient population.”
As a senior news writer for TriMed, Subrata covers cardiology, clinical innovation and healthcare business. She has a master’s degree in communication management and 12 years of experience in journalism and public relations.