Quality of heart failure care in managed Medicare and Medicaid patients in North Carolina

Am J Cardiol. 2004 Mar 15;93(6):714-8. doi: 10.1016/j.amjcard.2003.11.053.

Abstract

Use of angiotensin-converting enzyme (ACE) inhibitors and beta-adrenergic receptor blockers in patients with heart failure (HF) remains low despite the results of clinical trials and evidence-based guidelines that support their use. The quality of HF care in managed Medicare and Medicaid programs in North Carolina participating in a HF quality improvement program was assessed. Managed care plans identified adult patients with 1 inpatient or 3 outpatient claims for HF during 2000. A stratified random sample of 971 Medicare and 642 Medicaid patients' outpatient medical records from 5 plans were reviewed by trained nurse abstractors to obtain data regarding type of HF, demographics, comorbidities, and therapies. Left ventricular function assessment was performed in 88% of patients. Among 494 patients with systolic dysfunction, 86% were appropriately treated with respect to ACE inhibitors (73% prescribed, 13% had a documented contraindication). In contrast, beta-blocker therapy was appropriate in 61% (49% prescribed, 12% contraindication). There were no significant differences in drug use by insurance, gender, race, or age. Ventricular function assessment and ACE inhibitor prescription rates are higher than beta-blocker prescription rates among Medicare and Medicaid managed care patients in North Carolina. Opportunities for improvement remain, particularly for beta-blocker use.

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Adult
  • Aged
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Female
  • Guideline Adherence
  • Heart Failure / drug therapy*
  • Heart Failure / epidemiology*
  • Heart Failure / etiology
  • Humans
  • Male
  • Managed Care Programs / standards*
  • Medicaid / standards*
  • Medical Records
  • Medicare / standards*
  • Middle Aged
  • North Carolina / epidemiology
  • Quality Assurance, Health Care*
  • Retrospective Studies
  • Total Quality Management

Substances

  • Adrenergic beta-Antagonists
  • Angiotensin-Converting Enzyme Inhibitors