Managed Healthcare Executive - April 2009 - (Page 24) { HEALTH MANAGEMENT } Management of heart patients involves all stakeholders Clinicians, rehab experts, PBMs, consumer advocates, employers proactively manage this condition within their realms BY SHELLY REESE age 75, based on the National Heart, Lung, and Blood Institute’s Framingham Heart Study. In 2005, it accounted for one in every ve deaths in the United States. The AHA estimates the direct and indirect costs of coronary heart disease in 2009 will reach $165.4 billion. Employers, clinicians, rehab experts, PBMs and patient advocates are working to manage heart disease and curtail its costs within their particular sphere of in uence. Shelly Reese is a freelance writer based in Cincinnati, Ohio. 24 APRIL 2009 While clinical guidelines make evidencebacked recommendations for physicians to consider when managing patients, performance measures enable them to see how closely they’re sticking to guidelines in caring for myocardial infarction (MI, or “heart attack”) patients. Last fall, the American College of Cardiology and AHA jointly released a new set of clinical performance measures that enable hospitals and doctors to benchmark the quality of heart-attack care in several ACH YEAR, NEARLY 630,000 Americans areas, including prescribing statins upon die of heart disease and more than 4.2 million discharge, the timeliness of percutaneare hospitalized. It is considered the costliest ous coronary intervention (PCI) when condition overall, even outranking cancer. a patient must be transferred to another Cardiovascular disease cost $475.3 billion in hospital, referral to a cardiac rehabilitation direct and indirect costs last year alone, according program, and evaluation of the heart’s to the American Heart Assn. (AHA). Of the 80 pumping function (left ventricular systolic million people with the condition, 16.8 million function) during hospitalization. had coronary heart disease, which includes acute “Performance measures are extraordimyocardial infarction, angina pectoris, atheroscle- narily important in helping us learn how rotic cardiovascular disease, and all other forms of well we are doing and in providing targets chronic or acute ischemic heart disease. for improving quality,” Harlan KrumCoronary heart disease makes up more than half holz, MD, who chaired the performance of all cardiovascular events in men and women under measures writing committee, said in a Adam Gault/Digital Vision/Getty Images 1 CLINICIANS: APPLYING PERFORMANCE MEASURES E
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