Measure Source

Centers for Medicare and Medicaid Services (CMS), Health Care Quality Improvement Program Quality Indicator.

Tables

1.42a Percent of Medicare AMI patients with left ventricular systolic dysfunction prescribed ACE inhibitor at discharge, United States, 2002 and 2003.

1.42b Percent of Medicare AMI patients with left ventricular systolic dysfunction prescribed ACE inhibitor at discharge, by State, 2002 and 2003.

1.42c Percent of AMI patients with left ventricular systolic dysfunction prescribed ACE inhibitor at discharge, by State, 2004

Data Source

CMS, Medicare Quality Improvement Organization Program.

CMS, Hospital Compare.

Denominator

Medicare hospital discharges with a principal diagnosis of acute myocardial infarction (AMI), and with a left ventricular ejection fraction, and without angiotensin converting enzyme (ACE) inhibitor contraindication.

Numerator

Subset of AMI denominator patients who were prescribed an ACE inhibitor at hospital discharge.

Comments

ICD-9-CM codes for AMI include 410.01, 410.11, 410.21, 410.31, 410.41, 410.51, 410.61, 410.71, 410.81, and 410.91. The measure criteria exclude patients under age18, patients transferred to another acute care or Federal hospital, patients who expired, patients who left against medical advice, patients discharged to hospice, and patients with certain conditions or contraindications pertaining to ACEIs. Further information on this and other heart disease measures is available at http://www.cms.hhs.gov/QualityInitiativesGenInfo/.

Effective November 2004, CMS revised this measure to incorporate newly recognized treatment. NHQR 2005 tables and discussion refer to the prior version of the measure.

In the 2004 table, the State average percent was pre-calculated and supplied as part of the Hospital Compare database.