Regional Variations in Heart Failure Quality and Outcomes: Get With The Guidelines–Heart Failure Registry

Background Regional patient characteristics, care quality, and outcomes may differ based on a variety of factors among patients hospitalized for heart failure (HF). Regional disparities in outcomes of cardiovascular disease have been suggested across various regions in the United States. This study examined whether there are significant differences by region in quality of care and short‐term outcomes of hospitalized patients with HF across the United States. Methods and Results We examined regional demographics, quality measures, and short‐term outcomes across 4 US Census Bureau regions in patients hospitalized with HF and enrolled in the GWTG‐HF (Get With The Guidelines–Heart Failure) registry from 2010 to 2016. Differences in length of stay and mortality by region were examined with multivariable logistic regression. The study included 423 333 patients hospitalized for HF in 488 hospitals. Patients in the Northeast were significantly older. Completion of achievement measures, with few exceptions, were met with similar frequency across regions. Multivariable analysis demonstrated significantly lower in‐hospital mortality in the Midwest compared with the Northeast (hazard ratio, 0.64; 95% CI, 0.51–0.8; P <0.00001). The length of stay varied significantly by region with a significantly higher risk‐adjusted length of stay in the Northeast compared with other regions. Conclusions Although we did not find any substantial differences by region in quality of care in patients hospitalized for HF, risk‐adjusted inpatient mortality was found to be lower in the Midwest compared with the Northeast, and may be secondary to unmeasured differences in patient characteristics, and to longer length of stay in the Northeast.

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ICES Report: Quality of Care and Outcomes of Older Heart Failure Patients: Is the United States Doing a Better Job Than Canada?

Healthcare Quarterly ◽

10.12927/hcq..18098 ◽

2006 ◽

Vol 9 (2) ◽

pp. 26-27

Author(s):

Dennis Ko

Keyword(s):

United States ◽

Heart Failure ◽

Quality Of Care ◽

The United States ◽

Heart Failure Patients ◽

Report Quality

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Quality of Care and Outcomes of Older Patients With Heart Failure Hospitalized in the United States and Canada

Archives of Internal Medicine ◽

10.1001/archinte.165.21.2486 ◽

2005 ◽

Vol 165 (21) ◽

pp. 2486 ◽

Cited By ~ 52

Author(s):

Dennis T. Ko ◽

Jack V. Tu ◽

Frederick A. Masoudi ◽

Yongfei Wang ◽

Edward P. Havranek ◽

...

Keyword(s):

United States ◽

Heart Failure ◽

Quality Of Care ◽

Older Patients ◽

The United States ◽

Patients With Heart Failure

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Use of A Community of Practice For The Implementation of Evidence-Based Practices For Heart Failure Within The United States Department of Veterans Affairs

10.21203/rs.3.rs-387788/v1 ◽

2021 ◽

Author(s):

Anju Sahay ◽

Paul A. Heidenreich ◽

Brian S Mittman ◽

Parisa Gholami ◽

Shoutzu Lin

Keyword(s):

United States ◽

Heart Failure ◽

Quality Of Care ◽

The United States ◽

Veterans Affairs ◽

Evidence Based ◽

Department Of Veterans Affairs ◽

Clinical Practices ◽

Evidence Based Practices

Abstract Communities of Practice (CoPs) are a promising approach to facilitate the implementation of evidence-based practices (EBPs) to improve care for chronic conditions like heart failure (HF). COPs involve a complex process of acquiring and converting both explicit and tacit knowledge into clinical activities. Formation: In July 2006, a CoP called the Heart Failure Provider Network (HF Network) was established in the United States (US) Department of Veterans Affairs (VA) with the overarching goal of improving the quality of care for HF patients. The CoP has involved a total of 1,341 multidisciplinary and multilevel members at all 144 VA Health Care Systems (sites). Examples of CoP activities include discussions of interventions to decrease hospitalization rates and to empower patients and caregivers for self-management. Goals of the CoP include networking facilitation, information dissemination and exchange, collaboration and implementation of EBPs. Assessment: We conceptualized the assessment (formative evaluation) of the HF Network in terms of its various activities (inputs) and proximal impacts (mediators) at the individual-level, and its distal and ultimate impacts (outcomes) at the site-level leading to an improved culture of implementation of new/improved EBPs at the system-wide level. The HF Network membership grew steadily over the nine years. Most members were practicing clinicians (n = 891, 66.4%), followed by administrators (n = 342, 25.5%), researchers (n = 70, 5.2%), and others (n = 38, 2.8%). Participation was “active” for 70.9% versus “passive” for 29.4% of members. The distribution of active members (clinicians 64.7%, administrators 21.6%) was similar to the distribution of overall membership. Survey respondents perceived the HF Network as useful in terms of its varied activities and resources relevant for patient care. Members, particularly those that consider themselves influential in improving quality of care, noted multiple benefits of membership. These included confirmation of one’s own clinical practices, evidence-based changes to their practice and help in understanding facilitators and barriers in setting up or running HF clinics and other programs.

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Patient Characteristics and Outcomes of Type 2 Myocardial Infarction During Heart Failure Hospitalizations in the United States

The American Journal of Medicine ◽

10.1016/j.amjmed.2021.05.022 ◽

2021 ◽

Author(s):

Salik Nazir ◽

Abdul Mannan Khan Minhas ◽

Ishan S. Kamat ◽

Robert W. Ariss ◽

George V. Moukarbel ◽

...

Keyword(s):

United States ◽

Myocardial Infarction ◽

Heart Failure ◽

Patient Characteristics ◽

The United States

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National Trends in Emergency Department Use, Care Patterns, and Quality of Care of Older Adults in the United States

Journal of the American Geriatrics Society ◽

10.1111/jgs.12072 ◽

2013 ◽

Vol 61 (1) ◽

pp. 12-17 ◽

Cited By ~ 153

Author(s):

Jesse M. Pines ◽

Peter M. Mullins ◽

James K. Cooper ◽

Lisa B. Feng ◽

Katalin E. Roth

Keyword(s):

United States ◽

Older Adults ◽

Emergency Department ◽

Quality Of Care ◽

The United States ◽

Emergency Department Use ◽

Care Patterns ◽

National Trends

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Association of Electronic Health Record Use With Quality of Care and Outcomes in Heart Failure: An Analysis of Get With The Guidelines—Heart Failure

Journal of the American Heart Association ◽

10.1161/jaha.117.008158 ◽

2018 ◽

Vol 7 (7) ◽

Cited By ~ 7

Author(s):

Senthil Selvaraj ◽

Gregg C. Fonarow ◽

Shubin Sheng ◽

Roland A. Matsouaka ◽

Adam D. DeVore ◽

...

Keyword(s):

Heart Failure ◽

Quality Of Care ◽

Electronic Health Record ◽

Health Record ◽

Electronic Health ◽

Get With The Guidelines

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Telepsychiatry Use in Rural Areas in the United States

Journal of Information Technology Research ◽

10.4018/jitr.2020100101 ◽

2020 ◽

Vol 13 (4) ◽

pp. 1-13

Author(s):

Alberto Coustasse ◽

Morgan Ruley ◽

Tonnie C. Mike ◽

Briana M. Washington ◽

Anna Robinson

Keyword(s):

Mental Health ◽

United States ◽

Quality Of Care ◽

Rural Areas ◽

Care Delivery ◽

Mental Healthcare ◽

Healthcare Services ◽

The United States ◽

Access And Quality

Rural areas have experienced a higher than average shortage of healthcare professionals. Numerous challenges have limited access to mental health services. Some of these barriers have included transportation, number of providers, poverty, and lack of insurance. Recently, the utilization of telepsychiatry has increased in rural areas. The purpose of this review was to identify and coalesce the benefits of telepsychiatry for adults living in rural communities in the United States to determine if telepsychiatry has improved access and quality of care. The methodology for this study was a literature review that followed a systematic approach. References and sources were written in English and were taken from studies in the United States between 2004 and 2018 to keep this review current. Fifty-nine references were selected from five databases. It was found that several studies supported that telepsychiatry has improved access and quality of care available in rural environments. At the same time, telepsychiatry in mental healthcare has not been utilized as it should in rural adult populations due to lack of access, an overall shortage of providers, and poor distribution of psychiatrists. There are numerous benefits to implementing telepsychiatry in rural areas. While there are still barriers that prevent widespread utilization, telepsychiatry can improve mental health outcomes by linking rural patients to high-quality mental healthcare services that follow evidence-based care and best practices. Telepsychiatry utilization in rural areas in the United States has demonstrated to have a significant ability to transform mental health care delivery and clinician productivity. As technology continues to advance access, telepsychiatry will also advance, making access more readily available.

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