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2003 National Healthcare Quality Report

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Percent of AMI patients with beta blocker prescribed at discharge.

Measure Source

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

Tables

1.37a Percent of AMI patients with beta blocker prescribed at discharge, United States, 2000 - 2001.

1.37b Percent of AMI patients with beta blocker prescribed at discharge, 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

AMI patients prescribed a beta blocker at hospital discharge.

Comments

Excludes patients transferred to another acute care hospital, patients who expired and patients with unknown discharge disposition.

Excludes patients with one or more of the following beta blocker contraindications documented in the medical record: beta blocker allergy; beta blocker reaction during hospital stay; bradycardia during hospital stay; Last pulse less than 50 and did not receive beta blocker on discharge congestive heart failure(CHF)/pulmonary edema on arrival and left ventricular ejection fraction (LVEF) less than 50 or described as depressed to any degree; CHF on first chest x-ray and LVEF less than 50 or described as depressed to any degree; pulmonary edema on first chest x-ray and LVEF less than 50 or described as depressed to any degree; CHF/pulmonary edema during hospitalization and LVEF less than 50 or described as depressed to any degree; LVEF less than 30 or described as severe; shock on arrival or during hospital stay, hypotension during hospital stay; last systolic blood pressure less than 100 mm Hg and not discharged on a beta blocker; PR interval greater than .24 seconds on arrival electrocardiogram (ECG); second or third degree heart block on ECG; bifascicular block on ECG; Chronic Obstructive Pulmonary Disease; asthma; peripheral vascular disease.

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

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