Quality of Heart-Failure Care in Elders

Heart failure is the leading cause of hospitalization of Medicare patients and is associated with high readmission and mortality rates. Still, guideline-recommended heart-failure care often is not provided optimally. To gain insight into variation in care, researchers assessed two good indicators of quality (documentation of left-ventricular ejection fraction [LVEF] and ACE-inhibitor use) in the records of 30,228 Medicare patients (minimum age, 65) who had been hospitalized for heart failure.

Nationally, LVEF was documented in 67% of patients, and ACE inhibitors were prescribed to 66%. After adjustment for patient characteristics, low LVEF documentation rates had significant associations with several other characteristics: nonteaching hospit…