Health Care Quality Assessment

This section presents brief descriptions of each of the 4 IQIs and why it is important to report them publicly. As stated earlier, these indicators of healthcare quality are recommended to be reported as part of the “Outcome of Care” measures alongside other indicators presented in the Hospital Performance Report. Evidence has shown that with good care, deaths from these conditions can be minimized considerably.

AMI is a heart attack and can occur if the arteries supplying blood to the heart are blocked, and the blood supply is slowed or stopped. When arteries are blocked, the heart can’t get the oxygen and nutrients it needs to function properly. Symptoms of AMI can include chest pain (crushing, squeezing or burning pain in the center of the chest which may radiate to the arm or jaw), shortness of breath, dizziness, faintness, chills, sweating or nausea. Skin may feel cold or clammy, and patients may appear gray and look ill. Sometimes there are no symptoms.

This indicator measures the chance or likelihood that a heart attack patient admitted in a given hospital will die from that condition during hospitalization. According to the American Heart Association, if a heart attack victim gets to an emergency room fast enough, prompt care dramatically reduces heart damage. Timely and effective treatments for acute myocardial infarction (AMI), which are essential for patient survival, include appropriate use of revascularization or thrombolytic therapy. The rate shows the number of deaths per 100 AMI patients, age 18 years and older. For inclusion and exclusion criteria in calculating this rate, visit: http://www.qualityindicators.ahrq.gov/Modules/IQI_TechSpec.aspx

This information is important because it tells you how well hospitals take care of their heart attack patients. This measure takes into consideration several factors such as how quickly hospital staff treats a heart attack patient once they are in the emergency room.

Pneumonia is an inflammation of the lungs caused by an infection. Many different organisms can cause pneumonia, including bacteria, viruses and fungi. Pneumonia can range from very mild to very severe, even fatal, depending on the type of organism causing it as well as the age and current health of the individual. Symptoms for pneumonia can include fever, fatigue, difficulty breathing, chills, “wet” cough and chest pain.

This indicator measures the chance or likelihood that a pneumonia patient admitted in a given hospital will die from that condition during hospitalization. Pneumonia typically is treated with antibiotics, sometimes in an outpatient setting. However, death may occur even when the patient is in the hospital, especially in patients with weakened respiratory systems or other chronic health problems. There is a significant impact on outcomes from patient comorbidity factors as well as physician admitting practices (since there is variation in the criteria physicians use to admit patients for inpatient treatment). In-hospital pneumonia mortality rate is defined as deaths per 100 pneumonia patients, age 18 years and older. For inclusion and exclusion criteria in calculating this rate, visit: http://www.qualityindicators.ahrq.gov/Modules/IQI_TechSpec.aspx

This information is important because it tells you how well hospitals take care of their pneumonia patients.

HF is a weakening of the heart’s muscle which reduces its pumping power. Your body doesn’t get the oxygen and nutrients it needs when the heart muscles are weak to pump blood in a normal flow. Your heart tries to pump more blood, but over time the heart muscle walls weaken thereby causing heart failure. HF is one of the most common reasons for hospitalization. Symptoms for HF can include shortness of breath from fluid in the lungs, dizziness, fatigue, weakness, cold and clammy skin, or rapid and irregular heartbeat. HF can result from coronary artery disease, heart attack, cardiomyopathy (heart muscle damage from infection, alcohol or drugs), or an overworked heart bit caused by high blood pressure, kidney disease, diabetes, or a defect from birth.

This indicator measures the chance or likelihood that a HF patient admitted in a given hospital will die from that condition during hospitalization. HF is one of the most common and severe heart diseases affecting Americans, and one of the most common reasons for hospitalization. Congestion is the presence of an abnormal amount of fluid in the tissues, usually because of limitations in the body's ability to return the flow of blood from the arms or legs to the heart and lungs. Though HF has many possible underlying causes, the end result is an inability of the heart muscle to function well enough to meet the demands of the rest of the body. HF mortality is influenced greatly by other medical problems, including lung disease, high blood pressure, cancer and liver disease. The mortality rate for this measure is defined as the number of deaths per 100 HF patients, age 18 and older. For inclusion and exclusion criteria in calculating this rate, visit: http://www.qualityindicators.ahrq.gov/Modules/IQI_TechSpec.aspx

This information is important because it tells you how well hospitals take care of their heart failure (HF) patients. Since HF mortality is affected by other medical problems, including lung disease, high blood pressure, cancer and liver disease, the score measures how well the hospital can control these influences.

Acute Stroke is a disruption in the blood supply to the brain. A stroke occurs when a blood vessel (artery) bringing oxygen and nutrients to the brain bursts or is blocked by a blood clot or some other particle. Within minutes, the nerve cells in that area of the brain are damaged and may die within a few hours. As a result, the part of the body controlled by the damaged section of the brain cannot function properly. There are different types of strokes (ischemic, subarachnoid, and hemorrhagic). Treatment for stroke must be timely and efficient to prevent brain tissue death, and differs significantly based on which of the three types of stroke a patient has suffered. For example, clot-busting drugs are appropriate for strokes caused by clots, but could be fatal in the case of a burst blood vessel. Symptoms for acute stroke can include sudden numbness or weakness of the face, arm or leg, particularly on one side of the body; sudden confusion, trouble speaking or understanding, sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, loss of balance or coordination.

This indicator measures the chance or likelihood that an acute stroke patient admitted in a given hospital will die from that condition during hospitalization. Hospital specific stroke mortality rates will vary based on the cause of the stroke, the severity of the stroke, other patient illnesses, speed of arrival at the hospital, and speed of diagnosis of the type of stroke. Moreover, clinical factors, including use of mechanical ventilation on the first day, may vary by hospital and influence mortality. The mortality rate for Acute Stroke is defined as the number of deaths per 100 stroke patients, age 18 years and older. For inclusion and exclusion criteria in calculating this rate, visit: http://www.qualityindicators.ahrq.gov/Modules/IQI_TechSpec.aspx

This information is important because it tells you how well hospitals take care of their stroke patients. Treatment for stroke must be quick and efficient to prevent brain tissue death.