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Tracking core measures doesn't always translate into better outcomes

Respiratory Care Weekly, July 5, 2006

Adherence to CMS, Hospital Quality Alliance, and JCAHO core measures can't fully account for the variation in heart attack deaths at hospitals, according to the July 5 Journal of the American Medical Association. Researchers analyzed data on heart-attack patients 66 years old and older from 962 hospitals, and hospitals entered the data into a national heart-attack database during 2002-2003. While some measures, including smoking-cessation therapies, seem to help improve a patient's odds of surviving a heart attack, all the publicly reported measures can't reliably help a hospital determine the death rate of patients after they suffer a heart attack, the study concluded.

"Core measures are important in pursuing improved [heart attack] outcomes [but] they capture in aggregate only a small proportion of the hospital-level variation in short-term 30-day mortality rates," the researchers write. "Until additional process measures are developed that explain more of the variation, reporting not only the current core measures but also short-term risk-standardized mortality rates is a reasonable approach to characterize hospitals' overall quality of care."

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