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2005 National Healthcare Quality Report

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Median time to PTCA. Median time from arrival to percutaneous transluminal angioplasty (PTCA) in patients with ST segment elevation or left bundle branch block (LBBB) on the electrocardiogram (ECG) performed closest to hospital arrival time

Measure Source

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

Tables

1.45a Median time for Medicare AMI patients to PTCA, United States, 2002 and 2003.

1.45b Median time for Medicare AMI patients to PTCA, by State, 2002 and 2003.

1.45c Percent of AMI patients receiving percutaneous transluminal coronary angioplasty (PTCA) during the hospital stay with a time from hospital arrival to PTCA of 90 minutes or less, by State, 2004

Data Source

CMS, Medicare Quality Improvement Organization Program.

CMS, Hospital Compare.

Population

Medicare hospital discharges meeting all 3 of the following criteria:

  1. Principal diagnosis of acute myocardial infarction (AMI)
  2. ST segment elevation or LBBB on the ECG performed closest to the hospital arrival
  3. Percutaneous transluminal angioplasty performed during the hospital stay

Comments

Median time is time in minutes from arrival to percutaneous transluminal angioplasty (PTCA) in patients with ST segment elevation or left bundle branch block (LBBB) on the electrocardiogram (ECG) performed closest to hospital arrival time.

Effective October 2003, CMS revised this measure and re-titled it "Mean Time to PCI" (percutaneous coronary intervention). NHQR 2005 tables and discussion refer to the prior version of the measure.

ICD-9-CM codes for AMI include 410.01, 410.11, 410.21, 410.31, 410.41, 410.51, 410.61, 410.71, 410.81, and 410.91. The measure specifies exclusion of patients less than 18 years of age and patients transferred from other acute care hospitals, including other emergency departments, and patients administered thrombolytic agents. Further information on this and other heart disease measures is available at http://www.cms.hhs.gov/QualityInitiativesGenInfo/.

In the 2004 table, the State average percent was pre-calculated and supplied as part of the Hospital Compare database.

Recommended hospital care received by Medicare patients with heart failure. Median time in minutes to Thrombolysis. Time from arrival to initiation of a thrombolytic agent in patients with ST segment elevation or left bundle branch block (LBBB) on the electrocardiogram (ECG) performed closest to hospital arrival time.

 

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