OBJECTIVES: We sought to 1) determine the proportion of appropriate elderly @entity1 admitted to the hospital with @entity1459 who are treated with @entity117 and heparin; 2) identify @entity1 factors associated with the Agency for Health Care Policy and Research (AHCPR) guideline-based use of @entity117 and heparin; and 3) compare practice patterns and @entity1 outcomes before and after publication of the AHCPR guidelines. BACKGROUND: Improving the care of @entity1 with @entity1459 may provide immediate opportunities to mitigate the adverse consequences of @entity1459 . However, despite the importance of this diagnosis, there is a paucity of information on the patterns of treatment and outcomes across diverse sites and recent trends in practice that have occurred, especially since the publication of the AHCPR practice guidelines. METHOD: We performed a retrospective cohort study using data created from medical charts and administrative files. The sample included 300 consecutive @entity1 admitted to one of three Connecticut hospitals in the period 1993 to 1994 and 150 consecutive @entity1 admitted in 1995 with a principal discharge diagnosis of @entity1459 or @entity662 . RESULTS: Of the 384 @entity1 > or =65 years old who had no contraindications to @entity117 on hospital admission, 276 (72%) received it. Of the 369 @entity1 > or =65 years old who had no contraindications to heparin on admission, 88 (24%) received it. Among the 321 @entity1 > or =65 years old who had no contraindications to @entity117 at hospital discharge, 208 (65%) were prescribed it. When 1995 was compared with 1993 to 1994, the use of @entity117 (odds ratio [OR] 2.3, 95% confidence interval [CI] 1.3 to 4.0) and heparin (OR 2.8, 95% CI 1.6 to 4.9) on hospital admission significantly increased, and the use of @entity117 at discharge (OR 1.4, 95% CI 0.8 to 2.4) increased. Concomitantly, there was a significant reduction in 30-day readmission (OR 0.52, 95% CI 0.27 to 0.99). CONCLUSIONS: Our results indicate an improvement in the care and outcomes of elderly @entity1 with @entity1459 , but there remain opportunities for further improvement.

Trends in the quality of care for Medicare beneficiaries admitted to the hospital with XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity1459 :: ('MESH:D000789', 'Disease') :: ['unstable angina'] @entity117 :: ('MESH:D001241', 'Chemical') :: ['aspirin'] @entity662 :: ('MESH:D002637', 'Disease') :: ['chest pain']
@entity1459 :: (MESH:D000789,Disease) :: ['unstable angina']
