Circ Cardiovasc Qual
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Circ Cardiovasc Qual · May 2014
Impact of socioeconomic status measures on hospital profiling in New York City.
Current 30-day readmission models used by the Center for Medicare and Medicaid Services for the purpose of hospital-level comparisons lack measures of socioeconomic status (SES). We examined whether the inclusion of an SES measure in 30-day congestive heart failure readmission models changed hospital risk-standardized readmission rates in New York City (NYC) hospitals. ⋯ Although patients with higher SES were less likely to be admitted, the impact of SES on readmission was small. In NYC, inclusion of the AHRQ SES score in a CMS-based model did not impact hospital-level profiling based on 30-day readmission.
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Circ Cardiovasc Qual · May 2014
Effectiveness of a clinical decision support system for reducing the risk of QT interval prolongation in hospitalized patients.
We evaluated the effectiveness of a computer clinical decision support system (CDSS) for reducing the risk of QT interval prolongation in hospitalized patients. ⋯ A computer CDSS incorporating a validated risk score for QTc prolongation influences the prescribing of QT-prolonging drugs and reduces the risk of QTc interval prolongation in hospitalized patients with torsades de pointes risk factors.
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Little is known about the resuscitation preferences of patients with heart failure, how they may change over the course of the disease, and their association with mortality. ⋯ The resuscitation preferences of patients with heart failure seem to be driven by the decline in clinical status that often accompanies advanced age and multimorbidity. Furthermore, these data suggest that electing DNR status does not independently affect a patient's risk of death.