Quality of care of patients hospitalized with congestive heart failure
Contribuinte(s) |
E. Byrne |
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Data(s) |
01/01/2003
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Resumo |
Background: Congestive heart failure (CHF) is an increasingly prevalent poor-prognosis condition for which effective interventions are available. It is -therefore important to determine the extent to which patients with CHF receive appropriate care in Australian hospitals and identify ways for improving suboptimal care, if it exists. Aim: To evaluate the quality of in-hospital acute care of patients with CHF using explicit quality indicators based on published guidelines. Methods: A retrospective case note review was -performed, involving 216 patients admitted to three teaching hospitals in Brisbane, Queensland, Australia, between October 2000 and April 2001. Outcome measures were process-of-care quality -indicators calculated as proportions of all, or strongly -eligible (ideal), patients who received -specific interventions. Results: Assessment of underlying causes and acute precipitating factors was undertaken in 86% and 76% of patients, respectively, and objective evaluation of left ventricular function was performed in 62% of patients. Prophylaxis for deep venous thrombosis (DVT) was used in only 29% of ideal patients. Proportions of ideal patients receiving pharmacological treatments at discharge were: (i) angiotensin--converting enzyme inhibitors (ACEi) (82%), (ii) target doses of ACEi (61%), (iii) alternative vasodilators in patients ineligible for ACEi (20%), (iv) beta-blockers (40%) and (v) warfarin (46%). Conclusions: Opportunities exist for improving quality of in-hospital care of patients with CHF, -particularly for optimal prescribing of: (i) DVT prophylaxis, (ii) ACEi, (iii) second-line vasodilators, (iv) beta-blockers and (v) warfarin. More research is needed to identify methods for improving quality of in-hospital care. |
Identificador | |
Idioma(s) |
eng |
Publicador |
Blackwell Publishing Asia |
Palavras-Chave | #Medicine, General & Internal #Heart Failure #Hospital Care #Indicators #Quality #Converting Enzyme-inhibitors #Randomized Trial #Elderly Patients #Management Team #Improvement #Outcomes #Multidisciplinary #Epidemiology #Intervention #Mortality #C1 #730306 Evaluation of health outcomes #730106 Cardiovascular system and diseases #321003 Cardiology (incl. Cardiovascular Diseases) |
Tipo |
Journal Article |