JAMDA
Volume 10, Issue 1 , Pages 1-3 , January 2009

Cardiovascular Disease Care in the Nursing Home: The Need for Better Evidence for Outcomes of Care and Better Quality for Processes of Care

  • Ali Ahmed, MD, MPH

      Affiliations

    • Corresponding Author InformationAddress correspondence to Ali Ahmed, MD, MPH, 1530 3rd Avenue South, CH19–219, Birmingham, AL 35294–2041
    • ,
  • O. James Ekundayo, MBChB, DrPH

References 

  1. Ahmed A, Allman RM, DeLong JF, et al. Age-related underutilization of angiotensin-converting enzyme inhibitors in older hospitalized heart failure patients. South Med J. 2002;95:703–710
  2. Bierman AS. Sex matters: gender disparities in quality and outcomes of care. CMAJ. 2007;177:1520–1521
  3. Schneider EC, Zaslavsky AM, Epstein AM. Racial disparities in the quality of care for enrollees in medicare managed care. JAMA. 2002;287:1288–1294
  4. Aronow WS. Underutilization of aspirin in older patients with prior myocardial infarction at the time of admission to a nursing home. J Am Geriatr Soc. 1998;46:615–616
  5. Ahmed A, Weaver MT, Allman RM, et al. Quality of care of nursing home residents hospitalized with heart failure. J Am Geriatr Soc. 2002;50:1831–1836
  6. Ghosh S, Ziesmer V, Aronow WS. Underutilization of aspirin, beta blockers, angiotensin-converting enzyme inhibitors, and lipid-lowering drugs and overutilization of calcium channel blockers in older persons with coronary artery disease in an academic nursing home. J Gerontol A Biol Sci Med Sci. 2002;57:M398–M400
  7. Fahey T, Montgomery AA, Barnes J, Protheroe J. Quality of care for elderly residents in nursing homes and elderly people living at home: controlled observational study. BMJ. 2003;326:580
  8. Gupta G, Aronow WS. Underuse of procedures for diagnosing osteoporosis and of therapies for osteoporosis in older nursing home residents. J Am Med Dir Assoc. 2003;4:200–202
  9. Morley JE. Caring for the vulnerable elderly: Are available quality indicators appropriate?. J Am Med Dir Assoc. 2008;9:1–3
  10. Joseph J, Koka M, Aronow WS. Prevalence of moderate and severe renal insufficiency in older persons with hypertension, diabetes mellitus, coronary artery disease, peripheral arterial disease, ischemic stroke, or congestive heart failure in an academic nursing home. J Am Med Dir Assoc. 2008;9:257–259
  11. Jencks SF, Cuerdon T, Burwen DR, et al. Quality of medical care delivered to Medicare beneficiaries: A profile at state and national levels. JAMA. 2000;284:1670–1676
  12. Krumholz HM, Radford MJ, Wang Y, et al. National use and effectiveness of beta-blockers for the treatment of elderly patients after acute myocardial infarction: National Cooperative Cardiovascular Project. JAMA. 1998;280:623–629
  13. Levy CR, Radcliff TA, Williams ET, Hutt E. Acute myocardial infarction in nursing home residents—adherence to treatment guidelines reduces mortality, but why is adherence so low?. J Am Med Dir Assoc. 2008;
  14. Jencks SF, Huff ED, Cuerdon T. Change in the quality of care delivered to Medicare beneficiaries, 1998–1999 to 2000–2001. JAMA. 2003;289:305–312
  15. Krumholz HM, Radford MJ, Ellerbeck EF, et al. Aspirin in the treatment of acute myocardial infarction in elderly Medicare beneficiaries (Patterns of use and outcomes). Circulation. 1995;92:2841–2847
  16. Rosenbaum PR, Rubin DB. The central role of propensity score in observational studies for causal effects. Biometrika. 1983;70:41–55
  17. Rubin DB. Using propensity score to help design observational studies: Application to the tobacco litigation. Health Serv Outcomes Res Methodol. 2001;2:169–188
  18. Ahmed A, Husain A, Love TE, et al. Heart failure, chronic diuretic use, and increase in mortality and hospitalization: An observational study using propensity score methods. Eur Heart J. 2006;27:1431–1439
  19. Ahmed A, Aban IB, Vaccarino V, et al. A propensity-matched study of the effect of diabetes on the natural history of heart failure: variations by sex and age. Heart. 2007;93:1584–1590
  20. Ahmed A, Allman RM, Fonarow GC, et al. Incident heart failure hospitalization and subsequent mortality in chronic heart failure: a propensity-matched study. J Card Fail. 2008;14:211–218
  21. Ahmed A, Rich MW, Sanders PW, et al. Chronic kidney disease associated mortality in diastolic versus systolic heart failure: a propensity matched study. Am J Cardiol. 2007;99:393–398
  22. Michels KB, Braunwald E. Estimating treatment effects from observational data: dissonant and resonant notes from the SYMPHONY trials. JAMA. 2002;287:3130–3132

 Dr. Ahmed is supported by the National Institutes of Health through grants from the National Heart, Lung, and Blood Institute (5-R01-HL085561–02 and P50-HL077100), and a generous gift from Ms. Jean B. Morris of Birmingham, Alabama.

PII: S1525-8610(08)00324-1

doi: 10.1016/j.jamda.2008.08.019

JAMDA
Volume 10, Issue 1 , Pages 1-3 , January 2009

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