Clinical InvestigationCongestive Heart FailureGeneralizability and longitudinal outcomes of a national heart failure clinical registry: Comparison of Acute Decompensated Heart Failure National Registry (ADHERE) and non-ADHERE Medicare beneficiaries
Section snippets
Data sources
We accessed the ADHERE-Core registry and the 100% inpatient Medicare claims files to identify patients for this study. The institutional review board of the Duke University Health System (Durham, NC) approved the study. The design and objectives of ADHERE have been reported previously.2, 5 In brief, ADHERE was established to evaluate characteristics, treatments, and temporal trends in therapy and outcomes among patients hospitalized with acute decompensated heart failure. More than 300
Results
There were 187,138 unique records in the ADHERE registry, each representing a single hospitalization. Of those, 135,674 (72.5%) were hospitalizations of patients ≥65 years. Seven patients were not eligible for linking with Medicare claims data because they were missing data in critical fields. The 135,667 records eligible for linking with Medicare claims data were submitted by 306 hospitals. Of these hospitals, 279 (91.2%) were identified in the Medicare data. Most of the unidentified hospitals
Discussion
By using indirect identifiers to link ADHERE records to Medicare claims, we were able to evaluate postdischarge outcomes of fee-for-service Medicare beneficiaries in ADHERE. The analysis yielded several important findings. First, linking a unique, large clinical registry to Medicare data is feasible. Second, in the ADHERE registry, linked patients were similar to unlinked patients with respect to comorbid conditions and outcomes. Third, the ADHERE cohort has external validity (and hence,
Conclusion
ADHERE, a large hospital-based heart failure registry, can be linked to fee-for-service Medicare claims data. The ADHERE Medicare population is similar with respect to demographic characteristics and comorbid conditions to the general Medicare heart failure population, with the exception of slightly lower mortality in unadjusted analysis. The ADHERE Medicare population is similar to the elderly ADHERE population as a whole with respect to comorbid conditions and outcomes, with the exception of
Acknowledgements
Damon M. Seils, MA, Duke University, provided editorial assistance and prepared the manuscript. Mr Seils did not receive compensation for his assistance apart from his employment at the institution where the study was conducted.
References (22)
- et al.
Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF): rationale and design
Am Heart J
(2004) - et al.
Characteristics and in-hospital outcomes for nonadherent patients with heart failure: findings from Get With The Guidelines-Heart Failure (GWTG-HF)
Am Heart J
(2009) - et al.
Characteristics and outcomes of patients hospitalized for heart failure in the United States: rationale, design, and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE)
Am Heart J
(2005) - et al.
Linking inpatient clinical registry data to Medicare claims data using indirect identifiers
Am Heart J
(2009) - et al.
Are registry hospitals different? A comparison of patients admitted to hospitals of a commercial heart failure registry with those from national and community cohorts
Am Heart J
(2006) - et al.
Impact of race on health care utilization and outcomes in veterans with congestive heart failure
J Am Coll Cardiol
(2004) The potential role of community-based registries to complement the limited applicability of clinical trial results to the community setting: heart failure as an example
Am J Manag Care
(2004)The Acute Decompensated Heart Failure National Registry (ADHERE): opportunities to improve care of patients hospitalized with acute decompensated heart failure
Rev Cardiovasc Med
(2003)Registries and selection bias: the need for accountability
Circ Cardiovasc Qual Outcomes
(2009)- et al.
Patient registries of acute coronary syndrome: assessing or biasing the clinical real world data?
Circ Cardiovasc Qual Outcomes
(2009)
Representativeness of a national heart failure quality-of-care registry: comparison of OPTIMIZE-HF and non-OPTIMIZE-HF Medicare patients
Circ Cardiovasc Qual Outcomes
Cited by (0)
Trial registration: clinicaltrials.gov Identifier: NCT00366639.