How well hospitals follow guidelines for care of patients with heart failure may serve as a better quality metric than patient volume, according to a new study.
Researchers examined medical records for more than 125,000 patients, aged 65 or older with heart failure, who treated at 342 hospitals that follow guidelines established by the American Heart Association. The study followed these patients from 2005, when the guidelines launched, to 2014.
They found there was no difference in in-hospital mortality rates, 30-day readmission rates or 30-day mortality rates between low-volume and high-volume hospitals that closely followed the guidelines. The study did find that high patient volume was associated with a slight decrease in six-month mortality rates and readmission rates.
"Going to a high-volume medical center for heart failure doesn't guarantee that you'll have the best outcomes," lead author Dharam Kumbhani, M.D., a cardiologist at the University of Texas Southwestern Medical Center, said in an announcement.
"Identifying the hospitals that provide the best care is more complicated than that, and patients and health policymakers should recognize that smaller-volume hospitals can deliver outstanding care," he added.
Providers have called for more transparency in quality measures, especially as reporting poses a significant administrative burden. The Centers for Medicare & Medicaid Services have unveiled a number of new quality measures aimed at addressing these concerns.
The heart failure study also found that high-volume hospitals were more likely to adhere to "heart failure process measures," like appropriate testing and support for smoking cessation. These hospitals were also more likely to prescribe implantable medical devices to improve heart function.
Kumbhani said that the study should dispel the notion that high patient volumes are the only indicator of quality for certain conditions.
"What we have found in this study, and others we have conducted, is that patients at hospitals with established processes of care fare better," he said.