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2003 National Healthcare Quality Report

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Percent of AMI patients administered beta blocker within 24 hours of admission.

Measure Source

Centers for Medicare and Medicaid Services, Health Care Quality Improvement Program (HCQIP) Quality Indicator.

Tables

1.36a Percent of AMI patients administered beta blocker within 24 hours of admission, United States, 2000 - 2001.

1.36b Percent of AMI patients administered beta blocker within 24 hours of admission, by state, 2000 - 2001.

Data Source

Centers for Medicare and Medicaid Services, Medicare Quality Improvement Organization Program. Data are from a systematic random sample of up to 800 inpatient records per state.

Denominator

Medicare discharges with a principal diagnosis of acute myocardial infarction (AMI, ICD-9 codes 410.00, 410.01, 410.10, 410.11, 410.20, 410.21, 410.30, 410.31, 410.40, 410.41, 410.50 410.51, 410.60, 410.61, 410.70, 410.71, 410.80, 410.81, 410.90, 410.91).

Numerator

Subset of AMI denominator patients who received a beta blocker within 24 hours after hospital arrival.

Comments

Excludes patients transferred to another acute care hospital on day of arrival, patients received in transfer from another hospital or another emergency department, patients discharged on day of arrival, patients who expired on day of arrival, and patients of unknown source of admission.

Excludes patients with one or more of the following beta blocker contraindications documented in the medical record: beta blocker allergy; bradycardia (heart rate less than 60 bpm) on admission while not on a beta blocker; systolic blood pressure less than 100 mm Hg on admission; heart failure or shock on admission; PR interval greater than .24 seconds, second or third degree heart block or bifascicular block on admission electrocardiogram; history of Chronic Obstructive Pulmonary Disease, heart failure, asthma, or peripheral vascular disease; previous left ventricular ejection fraction less than 50 or described as depressed to any degree.

This measure is also a Joint Commission on Accreditation of Healthcare Organizations core measure.

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