More Medicare Patients Surviving Heart Attack

Heart attack care and Medicare
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If you are Medicare eligible and you have a heart attack, you are more likely today to survive the first 30 days after the episode than you would have more than a decade ago, according to a study published in the Journal of the American Medical Association. You are also likely to find more consistent quality of care among hospitals in terms of its treatment of heart attack survivors.

Between 1995, three years after Medicare instituted its own guidelines on appropriate treatment of heart attack victims, and 2006, the study’s authors found a 3 percent decline in the number of patients who died within one month of suffering their attack. In 2006, the 30-day mortality rate was 16.1 percent, down from 18.9 percent in 1995. The percentage of heart attack patients who died in the hospital also declined, from 14.6 percent in 1995 to 10.1 percent in 2006.

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To arrive at these figures, Dr. Harlan Krumholz of the Yale University School of Medicine and his colleagues evaluated the records of 2.7 million patients of Medicare age who had a heart attack between 1995 and 2006. According to a statement Dr. Krumholz gave to Reuters, “Although the cause of the reduction cannot be determined with certainty, this finding may reflect the success of the many individuals and organizations dedicated to improving care during this period.”

Prior to the heart attack treatment guidelines presented by Medicare and those published jointly by the American College of Cardiology and the American Heart Association in 1990, attempts to reduce heart attack death rates focused on identifying practitioners and hospitals that might be engaged in ineffective or harmful practices. Institution of the new guidelines, perhaps a combination of Medicare’s and those of the other two organizations, may be the reason for the decline in heart attack death rates.

The focus of the revised guidelines was on improving the entire system for handling heart attack patients by measuring and enhancing the quality of care at all hospitals as it relates to clinical guidelines and performance measures. Regardless of which organization’s guidelines have contributed to the decline in heart attack death rates among Medicare eligible patients, it is a trend that hopefully will continue.

SOURCES:
Reuters 8/18/09
WebMD 8/18/09

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