Quality of care for patients hospitalized with heart failure at academic medical centers.
Background The purpose of this study was to determine the standard of care provided by academic medical centers for the management of congestive heart failure (CHF).
Methods and Results The standard of care was estimated by assessing adherence to the treatment guidelines published by the US Agency for Health Care Policy and Research among 522 patients hospitalized at 7 university hospitals with a diagnosis of CHF.
Data were abstracted by retrospective chart review.
Of the 522 patients analyzed, 435 (83%) had a left ventricular ejection fraction (LVEF) measured or documented.
Among these patients, 192 were considered « ideal » candidates for angiotensin-converting enzyme (ACE) inhibitor therapy (ie, with systolic dysfunction [LVEF<40%) and no contraindications to ACE inhibitors).
In this cohort of « ideal » candidates, 138 (72%) were receiving ACE inhibitors at hospital discharge, including 60 (44%) who were prescribed doses recommended in large clinical trials.
Compliance with patient education guidelines was assessed in all 487 patients who were alive at the time of discharge.
Of these patients, 365 (75%) received dietary counseling, 404 (83%) were educated about exercise, 54 (11%) were instructed to follow daily weights, and 468 (96%) were counseled regarding medication compliance.
Among the 87 smokers who were alive at time of discharge, 8 (9%) had documented advice to quit smoking. (...)
Mots-clés Pascal : Insuffisance cardiaque, Hospitalisation, Qualité service, Soin, Santé, Fonction ventriculaire gauche, Education santé, Malade, Peptidyl-dipeptidase A, Peptidyl-dipeptidases, Peptidases, Hydrolases, Enzyme, Inhibiteur enzyme, Chimiothérapie, Traitement, Homme, Vasodilatateur, Appareil circulatoire pathologie, Cardiopathie, Angiotensin converting enzyme
Mots-clés Pascal anglais : Heart failure, Hospitalization, Service quality, Care, Health, Left ventricle performance, Health education, Patient, Peptidyl-dipeptidase A, Peptidyl-dipeptidases, Peptidases, Hydrolases, Enzyme, Enzyme inhibitor, Chemotherapy, Treatment, Human, Vasodilator agent, Cardiovascular disease, Heart disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0331504
Code Inist : 002B12A01. Création : 16/11/1999.