Hospital Volume and Processes, Outcomes, and Costs of Care for Congestive Heart Failure
Authors: Karen E. Joynt, E. John Orav, Ashish K. Jha
Journal: Annals of Internal Medicine (2011)

Letters2 August 2011Hospital Volume and Processes, Outcomes, and Costs of Care for Congestive Heart FailureKaren E. Joynt, MD, MPH, E. John Orav, PhD, and Ashish K. Jha, MD, MPHKaren E. Joynt, MD, MPHFrom Brigham and Women's Hospital and Harvard School of Public Health, Boston, MA 02115.Search for more papers by this author, E. John Orav, PhDFrom Brigham and Women's Hospital and Harvard School of Public Health, Boston, MA 02115.Search for more papers by this author, and Ashish K. Jha, MD, MPHFrom Brigham and Women's Hospital and Harvard School of Public Health, Boston, MA 02115.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-155-3-201108020-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Drs. Lin and Li bring up several points that we appreciate the opportunity to address.The cardiac intensive care numbers that Drs. Lin and Li cite (16% for low-volume, 37% for medium-volume, and 69% for high-volume hospitals) are not the proportion of patients that required intensive care, but the proportion of hospitals in each category that have a cardiac intensive care unit in their facility. Prior studies suggest that 4% to 5% of patients hospitalized with heart failure receive intensive care (1); without this service available on-site, transfer may have been necessary. Drs. Lin and Li also suggest ...References1. Singer AJ, Birkhahn RH, Guss D, Chandra A, Miller CD, Tiffany B, et al. Rapid Emergency Department Heart Failure Outpatients Trial (REDHOT II): a randomized controlled trial of the effect of serial B-type natriuretic peptide testing on patient management. Circ Heart Fail. 2009;2:287-93. [PMID: 19808351] CrossrefMedlineGoogle Scholar2. Desai MM, Lin Z, Schreiner GC, et al. 2009 Measures Maintenance Technical Report: Acute Myocardial Infarction, Heart Failure, and Pneumonia 30-Day Risk Standardized Readmission Measures. Baltimore, MD: Centers for Medicare & Medicaid Services 2009. Google Scholar3. LeLorier J, Grégoire G, Benhaddad A, Lapierre J, Derderian F. Discrepancies between meta-analyses and subsequent large randomized, controlled trials. N Engl J Med. 1997;337:536-42. [PMID: 9262498] CrossrefMedlineGoogle Scholar4. Birkmeyer JD, Siewers AE, Finlayson EV, Stukel TA, Lucas FL, Batista I, et al. Hospital volume and surgical mortality in the United States. N Engl J Med. 2002;346:1128-37. [PMID: 11948273] CrossrefMedlineGoogle Scholar5. Ross JS, Normand SL, Wang Y, Ko DT, Chen J, Drye EE, et al. Hospital volume and 30-day mortality for three common medical conditions. N Engl J Med. 2010;362:1110-8. [PMID: 20335587] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Brigham and Women's Hospital and Harvard School of Public Health, Boston, MA 02115.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M10-1177. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Association Between Hospital Volume and Processes, Outcomes, and Costs of Care for Congestive Heart Failure Karen E. Joynt , E. John Orav , and Ashish K. Jha Hospital Volume and Processes, Outcomes, and Costs of Care for Congestive Heart Failure Gen-Min Lin and Yi-Hwei Li Metrics 2 August 2011Volume 155, Issue 3Page: 202-203KeywordsClinical trialsConflicts of interestDatabasesDisclosureHeart failureHospitalsLongitudinal studiesMedicarePatients ePublished: 2 August 2011 Issue Published: 2 August 2011 CopyrightCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...