RESOURCE USE AND QUALITY OF CARE FOR MEDICARE PATIENTS WITH ACUTE MYOCARDIAL-INFARCTION IN MARYLAND AND THE DISTRICT-OF-COLUMBIA - ANALYSISOF DATA FROM THE COOPERATIVE CARDIOVASCULAR PROJECT

This study sought to evaluate the quality of care rendered to Medicare beneficiaries with acute myocardial infarction by establishing the us e patterns of well-proven therapies in this population. We analyzed th e quality of care rendered to 4300 Medicare beneficiaries seen at Mary land and District of Columbia hospitals with retrospectively confirmed acute myocardial infarction by evaluating the use of proven therapies . The proportion of patients ideal for therapies ranged from 10% for r eperfusion to 100% for smoking cessation counseling. For ideal patient s the following therapies were implemented: aspirin (87%), reperfusion therapy (64%), beta-blockers on discharge (60%), and smoking cessatio n counseling (41%). A substantial proportion of Medicare patients with acute myocardial infarction has one or more relative or absolute cont raindications to standard regimens and therefore are not ideal therape utic candidates. In the group of ideal patients, those with no therape utic contraindications, a significant proportion do not receive these treatments.