Release Notes:
Measure Information Form
Version 2010B
**NQF-ENDORSED VOLUNTARY CONSENSUS STANDARDS FOR HOSPITAL CARE**Measure Information Form
Measure Set: Acute Myocardial Infarction(AMI)
Set Measure ID: AMI-9
Performance Measure Name: Inpatient Mortality
Description: Acute myocardial infarction (AMI) patients who expired during hospital stay
Rationale: Mortality of patients with AMI represents a significant outcome potentially related to quality of care. This rate-based indicator identifies an undesirable outcome of care. High rates over time may warrant investigation into the quality of care provided.
Type of Measure: Outcome
Improvement Noted As: Decrease in the rate
Numerator Statement: Inpatient mortality of AMI patients
Included Populations: Not applicable
Excluded Populations: None
Data Elements:
Denominator Statement: AMI patients
Included Populations:
- Discharges with an ICD-9-CM Principal Diagnosis Code for AMI as defined in Appendix A, Table 1.1
Excluded Populations:
- Patients less than 18 years of age
- Patients who have a Length of Stay >120 days
- Patients with Comfort Measures Only documented
- Patients enrolled in clinical trials
- Patients received as a transfer from an acute care facility where they were an inpatient or outpatient
- Patients received as a transfer from one distinct unit of the hospital to another distinct unit of the same hospital
- Patients discharged/transferred to another hospital for inpatient care
- Patients discharged/transferred to a federal health care facility
- Patients discharged/transferred to hospice
Note:
The measure population does not include deaths that occurred in the emergency department.
Data Elements:
Continuous Variable Statement:
Included Populations:
Excluded Populations:
Data Elements:
Risk Adjustment: Yes. Refer to the ORYX Risk Adjustment Guide. This guide is available to the public on the Joint Commission's website and, in addition, it is available to performance measurement systems via the Joint Commission's extranet site for measurement systems (PET).
Data Elements:
Data Collection Approach: Retrospective data sources for required data elements include administrative data and medical records.
Data Accuracy: Variation may exist in the assignment of ICD-9-CM codes; therefore, coding practices may require evaluation to ensure consistency.
Measure Analysis Suggestions: None
Sampling: Yes. For additional information see the Sampling Section.
Data Reported As: Aggregate rate generated from count data reported as a proportion.
Selected References:
- Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, Hand M, Hochman JS, Krumholz HM, Kushner FG, Lamas GA, Mullany CJ, Ornato JP, Pearle DL, Sloan MA, Smith SC Jr. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction). 2004.
- Maggioni AP, et al: Age related increase in mortality among patients with first myocardial infarctions treated with thrombolysis: the Investigators of the Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico (GISSI-2). N Engl J Med. 329:1442-1448, 1993.
Measure Algorithm:
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