Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Care for IHD and CHF Varies in VA Health System

JAMA Cardiol; ePub 2018 May 16; Groeneveld, et al

Risk-standardized mortality rates for ischemic heart disease (IHD) and chronic heart failure (CHF) varied widely across the Veterans Affairs (VA) health system, signaling potential substantial differences in the quality of cardiovascular (CV) care between VA medical centers (VAMC). This according to a retrospective cohort study comprising 138 VA hospitals and including patients who received VA inpatient or outpatient care between 2010 and 2014. Separate cohorts were developed for patients diagnosed as having either IHD or CHF and researchers sought to determine whether there are substantial differences in CV outcomes across VAMCs. They found:

  • Among the 930,079 veterans with IHD (mean age 77 years) receiving care, annual risk-standardized mortality rates varied from 5.5% to 9.4%.
  • Among the 348,015 veterans with CHF (mean age 77 years) receiving care, annual risk-standardized mortality rates varied from 11.1% to 18.9%.
  • VAMCs’ mortality rates among their IHD and CHF populations were not associated with 30-day mortality rates for myocardial infarction and weakly associated with hospitalized heart failure 30-day mortality.

Citation:

Groeneveld PW, Medvedeva EL, Walker L, Segal AG, Richardson DM, Epstein AJ. Outcomes of care for ischemic heart disease and chronic heart failure in the Veterans Health Administration. [Published online ahead of print May 16, 2018]. JAMA Cardiol. doi:10.1001/jamacardio.2018.1115.