Table 2.
Achievement and Quality Measures at Discharge
| Overall | Northeast | Midwest | South | West | Abs. Stand. Diff. (*=Significant, >10) | |||
|---|---|---|---|---|---|---|---|---|
| Midwest vs Northeast | South vs Northeast | West vs Northeast | ||||||
| Achievement measures (%) | ||||||||
| ACEI/ARB or ARB–neprilysin inhibitor | 94.5 | 95.1 | 95.1 | 94.3 | 93.3 | 0.01 | 3.83 | 7.79 |
| Evidence‐based beta‐blocker | 89.9 | 89.7 | 89.7 | 89.7 | 91.5 | 0.07 | 0.02 | 6.33 |
| Postdischarge appointment for HF | 61.3 | 60.1 | 69.1* | 58.6 | 56.2 | 18.90* | 3.02 | 7.90 |
| Measurement of LV function | 100 | 100 | 100 | 100 | 100 | 0.00 | 0.00 | 0.00 |
| Composite achievement measure | 85.8+21.6 | 86.0+21.5 | 88.4*+20.4 | 84.5+22.0 | 83.7*+22.6 | 11.30* | 7.17 | 10.51* |
| Quality measures, % | ||||||||
| Aldosterone antagonist | 41.9 | 44.4 | 41.1 | 37.8* | 48.7 | 6.84 | 13.6* | 8.56 |
| Hydralazine/nitrate | 26.4 | 26.7 | 27.3 | 25.8 | 25.1 | 1.34 | 1.93 | 3.75 |
| CRT‐D/CRT‐P placed or prescribed | 51.2 | 55.8 | 56.4 | 47.0* | 42.4* | 1.35 | 17.5* | 26.9* |
| ICD placed or prescribed | 63.7 | 71.2 | 67.0 | 60.3* | 53.2* | 9.3 | 23.1* | 37.9* |
| Follow‐up visit within ≤7 d | 75.9 | 80.1 | 77.2 | 71.0* | 76.4 | 7.1 | 21.5* | 9.0 |
| Anticoagulation for atrial fibrillation, n | 109 427 (81.5) | 37 131 (86.7) | 28 362 (82.1)* | 29 856 (77.2)* | 14 078 (77.6)* | 12.6* | 24.7* | 23.9* |
| DVT prophylaxis | 83.7 | 86.6 | 82.4* | 81.7* | 84.1 | 11.5* | 13.4* | 6.8 |
| Influenza vaccine during flu season | 84.1 | 82.6 | 84.6 | 84.4 | 85.8 | 5.5 | 5.0 | 8.8 |
| Pneumococcal vaccination | 79.1 | 79.9 | 79.3 | 78.2 | 78.7 | 1.6 | 4.3 | 3.0 |
| Overall composite performance measure | 80.1+19.9 | 81.9±19.6 | 81.4±19.7 | 77.8*±20.0 | 78.6*±19.8 | 2.7 | 20.9* | 16.7* |
The denominator for each measure is appropriate patients without contraindication for each measure. Composite achievement measure: composite of the 4 achievement measures=number of measure performed/number of eligible measure×100. ACEI indicates angiotensin‐converting enzyme inhibitor; ARB, angiotensin receptor blocker; CRT‐D/CRT‐P, cardiac resynchronization therapy with defibrillator/pacemaker only; DVT, deep venous thrombosis; HF, heart failure; ICD, implantable cardioverter‐defibrillator; and LV, left ventricle.
*
Abs. Stand. diff.=absolute standardized difference, >10% was considered significant; regions with abs. stand. diff. >10% for a variable compared with the Northeast region.