Table 3.
Monthly Core Measure Performance Rates Adjusted for Patient Characteristics and Secular Trends*
| Composite core measure† | Odds ratio‡ | 95% CI | P value |
|---|---|---|---|
| Heart failure | |||
| Pre-MDR§ | 1.02 | 0.98–1.05 | .397 |
| MDR§ | 1.06 | 1.03–1.10 | .001 |
| Acute myocardial infarction | |||
| Pre-MDR | 1.12 | 1.00–1.25 | .057 |
| MDR | 1.05 | 0.93–1.20 | .434 |
| Community-acquired pneumonia | |||
| Pre-MDR | 1.12 | 1.05–1.19 | .001 |
| MDR | 1.22 | 1.15–1.29 | <.001 |
| Aggregated | |||
| Pre-MDR | 1.05 | 1.02–1.08 | .001 |
| MDR | 1.09 | 1.06–1.12 | <.001 |
*Adjusted using linear spline logistic regression modeling. Patient characteristics include age, gender, and comorbidities including COPD, diabetes mellitus, hypertension, and dementia.
†CHF: discharge instructions, LVF assessment, ACEI for LVSD, smoking-cessation counseling. AMI: aspirin at discharge, ACEI for LVSD, smoking-cessation counseling, and beta blocker at discharge. Pneumonia: pneumococcal vaccination and smoking cessation counseling.
‡The odds ratio reflects changes in monthly performance. A ratio of greater than 1 indicates that monthly core measure performance is increasing.
§Month as an interval