Mental disorders, quality of care, and outcomes among older patients hospitalized with heart failure: An analysis of the national heart failure project

Abstract

Objective: To evaluate the effect of a mental illness diagnosis on quality of care and outcomes among patients with heart failure. Design: Retrospective, national, population-based sample of patients with heart failure hospitalized from April 1, 1998, through March 31, 1999, and July 1, 2000, through June 30, 2001. Setting: Nonfederal US acute care hospitals. Patients: A total of 53 314 Medicare beneficiaries. Main Outcome Measures: Quality of care measures, including left ventricular ejection fraction (LVEF) assessment, prescription of an angiotensin-converting enzyme (ACE) inhibitor at discharge among patients without treatment contraindications, and 1-year readmission and 1-year mortality. Results: Of the patients included in the study, 17.0% had a mental illness diagnosis. Compared with patients without mental illness diagnoses, eligible patients with mental illness diagnoses had lower rates of LVEF evaluation (53.0% vs 47.3%; P