Hospital Quality for Acute Myocardial Infarction

Abstract

As part of the national effort to improve hospital quality, the Centers for Medicare & Medicaid Services (CMS) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) monitor and publicly report hospital performance on acute myocardial infarction (AMI) “core” process measures approved by the Hospital Quality Alliance.¹ Although the CMS/JCAHO process measures are considered indicators of quality of AMI care,² little is known about how these measures track with each other. Five of the 7 CMS/JCAHO process measures assess medication prescription practices. Because these processes are likely to be amenable to similar quality improvement interventions, one might expect them to be strongly correlated at the hospital level. In contrast, timely reperfusion therapy, which involves coordination among various hospital services and personnel,³ may require other types of interventions and thus be less strongly correlated with the other process measures. Understanding how process measures are themselves correlated can suggest how sensitive hospital performance rankings may be to the process measures that are included.