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Quality of care of and outcomes for African Americans hospitalized with heart failure: findings from the OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure) registry.
J Am Coll Cardiol. 2008 Apr 29; 51(17):1675-84.JACC

Abstract

OBJECTIVES

We sought to examine the characteristics, quality of care, and clinical outcomes for a large cohort of African-American patients hospitalized with heart failure (HF) in centers participating in a quality improvement initiative.

BACKGROUND

Heart failure in African Americans is characterized by variations in natural history, lesser response to evidence-based therapies, and disparate health care. We hypothesized that a performance improvement program will achieve similar adherence to quality measures in African Americans admitted with HF compared with non-African Americans.

METHODS

The OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure) registry-based performance-improvement program includes a pre-specified 10% subgroup with 60- to 90-day follow-up. Data on quality of care measures and outcomes were analyzed for 8,608 African-American patients compared with 38,501 non-African-American patients.

RESULTS

African Americans were significantly younger and more likely to receive evidence-based medications but less likely to receive discharge instructions and smoking cessation counseling. In multivariable analyses, African-American race was an independent predictor of lower in-hospital mortality (odds ratio 0.71; 95% confidence interval 0.57 to 0.87; p < 0.001) but similar hospital length of stay. After multivariable adjustment, post-discharge outcomes were similar for American-American and non-African-American patients, but African-American race was associated with higher angiotensin-converting enzyme inhibitor prescription and left ventricular function assessment; no other HF quality indicators were influenced by race.

CONCLUSIONS

In the context of a performance-improvement program, African Americans with HF received similar or better treatment with evidence-based medications, less discharge counseling, had better in-hospital survival, and similar adjusted risk of follow-up death/repeat hospital stay.

Authors+Show Affiliations

Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, Texas 75246, USA. clydey@baylorhealth.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18436120

Citation

Yancy, Clyde W., et al. "Quality of Care of and Outcomes for African Americans Hospitalized With Heart Failure: Findings From the OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure) Registry." Journal of the American College of Cardiology, vol. 51, no. 17, 2008, pp. 1675-84.
Yancy CW, Abraham WT, Albert NM, et al. Quality of care of and outcomes for African Americans hospitalized with heart failure: findings from the OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure) registry. J Am Coll Cardiol. 2008;51(17):1675-84.
Yancy, C. W., Abraham, W. T., Albert, N. M., Clare, R., Stough, W. G., Gheorghiade, M., Greenberg, B. H., O'Connor, C. M., She, L., Sun, J. L., Young, J. B., & Fonarow, G. C. (2008). Quality of care of and outcomes for African Americans hospitalized with heart failure: findings from the OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure) registry. Journal of the American College of Cardiology, 51(17), 1675-84. https://doi.org/10.1016/j.jacc.2008.01.028
Yancy CW, et al. Quality of Care of and Outcomes for African Americans Hospitalized With Heart Failure: Findings From the OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure) Registry. J Am Coll Cardiol. 2008 Apr 29;51(17):1675-84. PubMed PMID: 18436120.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Quality of care of and outcomes for African Americans hospitalized with heart failure: findings from the OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure) registry. AU - Yancy,Clyde W, AU - Abraham,William T, AU - Albert,Nancy M, AU - Clare,Robert, AU - Stough,Wendy Gattis, AU - Gheorghiade,Mihai, AU - Greenberg,Barry H, AU - O'Connor,Christopher M, AU - She,Lilin, AU - Sun,Jie Lena, AU - Young,James B, AU - Fonarow,Gregg C, PY - 2007/07/30/received PY - 2008/01/24/revised PY - 2008/01/29/accepted PY - 2008/4/26/pubmed PY - 2008/6/5/medline PY - 2008/4/26/entrez SP - 1675 EP - 84 JF - Journal of the American College of Cardiology JO - J Am Coll Cardiol VL - 51 IS - 17 N2 - OBJECTIVES: We sought to examine the characteristics, quality of care, and clinical outcomes for a large cohort of African-American patients hospitalized with heart failure (HF) in centers participating in a quality improvement initiative. BACKGROUND: Heart failure in African Americans is characterized by variations in natural history, lesser response to evidence-based therapies, and disparate health care. We hypothesized that a performance improvement program will achieve similar adherence to quality measures in African Americans admitted with HF compared with non-African Americans. METHODS: The OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure) registry-based performance-improvement program includes a pre-specified 10% subgroup with 60- to 90-day follow-up. Data on quality of care measures and outcomes were analyzed for 8,608 African-American patients compared with 38,501 non-African-American patients. RESULTS: African Americans were significantly younger and more likely to receive evidence-based medications but less likely to receive discharge instructions and smoking cessation counseling. In multivariable analyses, African-American race was an independent predictor of lower in-hospital mortality (odds ratio 0.71; 95% confidence interval 0.57 to 0.87; p < 0.001) but similar hospital length of stay. After multivariable adjustment, post-discharge outcomes were similar for American-American and non-African-American patients, but African-American race was associated with higher angiotensin-converting enzyme inhibitor prescription and left ventricular function assessment; no other HF quality indicators were influenced by race. CONCLUSIONS: In the context of a performance-improvement program, African Americans with HF received similar or better treatment with evidence-based medications, less discharge counseling, had better in-hospital survival, and similar adjusted risk of follow-up death/repeat hospital stay. SN - 1558-3597 UR - https://www.unboundmedicine.com/medline/citation/18436120/Quality_of_care_of_and_outcomes_for_African_Americans_hospitalized_with_heart_failure:_findings_from_the_OPTIMIZE_HF__Organized_Program_to_Initiate_Lifesaving_Treatment_in_Hospitalized_Patients_With_Heart_Failure__registry_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(08)00565-2 DB - PRIME DP - Unbound Medicine ER -