Measure Source

Centers for Medicare and Medicaid Services (CMS), Health Care Quality Improvement Program Quality Indicator.

Tables

1.44a Median time for Medicare AMI patients to thrombolysis, United States, 2002 and 2003.

1.44b Median time for Medicare AMI patients to thrombolysis, by State, 2002 and 2003.

Data Source

CMS, Medicare Quality Improvement Organization Program.

Population

Medicare hospital discharges meeting all 3 of the following criteria:

1. Principal diagnosis of acute myocardial infarction (AMI)
2. ST segment elevation or LBBB on the ECG performed closest to the hospital arrival
3. Thrombolytic therapy during the hospital stay

Comments

Median time is in minutes from arrival to initiation of a thrombolytic agent in patients with ST segment elevation or left bundle branch block (LBBB) on the electrocardiogram (ECG) performed closest to hospital arrival time.

Effective October 2003, CMS revised this measure and re-titled it "Mean Time to Thrombolysis." NHQR 2005 tables and discussion refer to the prior version of the measure.

ICD-9-CM codes for AMI include 410.01, 410.11, 410.21, 410.31, 410.41, 410.51, 410.61, 410.71, 410.81, and 410.91. The measure specifies exclusion of patients less than 18 years of age and patients transferred from another acute care hospital, including another emergency department. Further information on this and other heart disease measures is available at http://www.cms.hhs.gov/QualityInitiativesGenInfo/.