AJC: Chest pain center accreditation linked with better outcomes in MI patients

Hospitals accredited by the Society of Chest Pain Centers have been shown to perform better in the heart attack core measures established by Centers for Medicare & Medicaid Services (CMS) as compared to non-accredited hospitals, according to a national study reported in the July issue of the American Journal of Cardiology.

The SCPC was established in 1998, and involves a collaboration of physicians, nurses and healthcare experts from cardiology, emergency medicine, nuclear medicine and clinical pathology. Through reviews of published research and expert consensus, the society developed criteria for the accreditation of chest pain centers.

Michael Ross, MD, associate professor and medical director for observation medicine at the Emory University School of Medicine, and colleagues undertook the study to determine whether hospitals accredited by the Society of Chest Pain Centers (SCPC) hospitals are associated with better performance regarding CMS core measures for acute MI (AMI) than nonaccredited hospitals.

“To achieve accreditation, an institution must submit documentation and participate in a site visit conducted by SCPC reviewers,” Ross said. “The number of centers that applied for and received accreditation increased dramatically from June 2003 when the first hospital chest pain center was accredited. Now 364 accredited chest pain centers are being accredited as of January.”

“Although the number of accredited hospitals has steadily risen during the past five years, no studies until now have actually compared clinical outcomes or compliance with core measures for the management of AMIs in patients served by hospitals with accredited or non-accredited centers,” Ross and colleagues noted.

CMS has established core measures for AMI for all hospitals that bill for the care of Medicare patients, the authors wrote. The measures are considered to represent best practices for the care of patients with AMIs, and their reporting is required.

Overall, the researchers found that there were 395,250 patients with AMIs, of whom 55,418 (14 percent) presented to accredited CPCs and 339,832 (86 percent) presented to nonaccredited hospitals. There was significantly greater compliance with all eight AMI core measures at accredited CPCs, except for lytic therapy <30 minutes after arrival, for which unadjusted performance was the same, Ross and colleagues wrote.

Increased adherence to the core measures might also lead to more heart attack patients receiving emergency angioplasty within 120 minutes—the door-to-balloon benchmark used at the time of reporting, the authors noted.

The researchers concluded that if all hospitals performed CMS core measures at levels reported by those with accredited chest pain centers, more MI patients would be treated with aspirin and beta blockers at both arrival and discharge from the hospital.