Skip Navigation Archive: U.S. Department of Health and Human Services U.S. Department of Health and Human Services
Archive: Agency for Healthcare Research Quality www.ahrq.gov
AHRQ Home—Live Site | Archive Home | Site Map
Archival print banner

This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://info.ahrq.gov. Let us know the nature of the problem, the Web address of what you want, and your contact information.

Please go to www.ahrq.gov for current information.

Chartbook on Effective Treatment

Cardiovascular Disease: Treatment of Heart Attack

Fibrinolytic Medication

Hospital patients with heart attack given fibrinolytic medication within 30 minutes of arrival, by sex and race/ethnicity, 2005-2012

Chart shows hospital patients with heart attack given fibrinolytic medication within 30 minutes of arrival, by sex and ethnicity. Go to tables below for details.

Left Chart:

Sex 2005 2006 2007 2008 2009 2010 2011 2012
Total 37.9 42.1 50 49.4 54.4 58.4 57.9 62.3
Female 31.1 34.6 42 43.0 49.8 51.3 49.6 56.9
Male 41.1 45.2 53.3 52.1 56.3 61.2 61.1 64.6

2008 Achievable Benchmark: 68%.

Right Chart:

Race / Ethnicity 2005 2006 2007 2008 2009 2010 2011 2012
White 38.7 43.6 51.8 51.0 55.7 63.8 57.3 62.5
Black 27.7 32.6 44.5 37.8 46.8 53 58.2 58.5
Hispanic 36.8 37.8 43.2 47.6 52.8 47.3 57 60.8
Asian 43.9 45.5 55.5 48.2 58.6 67.3 71.4  

2008 Achievable Benchmark: 68%.

Source: Centers for Medicare & Medicaid Services, Medicare Quality Improvement Organization Program, 2005-2012.
Denominator: Discharged hospital patients with a principal diagnosis of acute myocardial infarction and documented receipt of thrombolytic therapy during the hospital stay.
Note: Data for Asians in 2012 were statistically unreliable.

  • Importance: Some heart attacks are caused by blood clots. Early actions, such as fibrinolytic medication, may open blockages caused by blood clots, reduce heart muscle damage, and save lives. To be effective, these actions need to be performed quickly after the start of a heart attack.
  • Trends: From 2005 to 2012, the percentage of patients who received timely fibrinolytic medication improved overall, for both sexes, and for all racial/ethnic groups.
  • Groups With Disparities:
    • Until 2012, the percentage of patients who received timely fibrinolytic medication was significantly higher for males than for females.
    • Until 2011, the percentage of patients who received timely fibrinolytic medication was significantly higher for Whites than for Blacks.
  • Achievable Benchmark:
    • The 2010 top 5 State achievable benchmark was 68%. The top 5 States that contributed to the achievable benchmark are Arkansas, California, Georgia, Mississippi, and Texas.
    • Asian heart attack patients achieved the benchmark in 2011.
    • At the current rate of improvement, the achievable benchmark could be attained overall in 2 years.
    • Male heart attack patients should reach the achievable benchmark in 1 year and females in 3 years.
    • White, Black, and Hispanic heart attack patients should reach the benchmark in 2 years.

Inpatient Deaths

Inpatient deaths per 1,000 adult hospital admissions with heart attack, by expected payment source, 2000-2012

Chart shows inpatient deaths per 1,000 adult hospital admissions with heart attack, by expected payment source. Go to table below for details.

Payment Source 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Total 102.4 98.3 91.8 85.2 79.9 74.7 69.9 65.0 57.9 53.0 50.2 48.7 47.6
Private 85.9 83.6 74.2 70.4 67.6 65.5 63.1 58.8 56.3 49.0 46.3 49.9 44.5
Medicaid 105.8 101.2 94.9 87.6 81.8 75.8 70.7 65.5 57.5 52.7 50.0 47.5 47.2
Medicare 93.2 98.9 87.9 81.2 82.1 72.6 69.2 68.0 57.8 53.0 50.4 49.3 48.3
Uninsured 114.9 101.3 101.7 93.1 88.0 85.7 79.3 79.2 76.0 67.1 66.7 62.3 66.7

2012 Achievable Benchmark: 39 Deaths per 1,000 Admissions.

Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, Nationwide Inpatient Sample and AHRQ Quality Indicators, version 4.4, 2000-2012.
Denominator: Adults age 18 and over admitted to a non-Federal community hospital in the United States with acute myocardial infarction as principal discharge diagnosis.
Note: For this measure, lower rates are better. Rates are adjusted by age, major diagnostic category, all payer refined-diagnosis related group risk of mortality score, and transfers into the hospital.

  • Importance: Heart attack is a common life-threatening condition that requires rapid recognition and efficient treatment in a hospital to reduce the risk of serious heart damage and death.
  • Trends: From 2000 to 2012, the risk-adjusted inpatient mortality rate for hospital admissions with heart attack decreased significantly overall and for all insurance groups.
  • Groups With Disparities: In all years, uninsured patients had higher inpatient mortality rates for hospital admissions with heart attack than privately insured patients.
  • Achievable Benchmark:
    • The 2008 top 4 State achievable benchmark for inpatient heart attack mortality was 48 deaths per 1,000 admissions. By 2012, this benchmark had been attained overall and for all insurance groups except uninsured patients.
    • Because the 2008 benchmark was achieved by the total population, a new 2012 top 4 State achievable benchmark was set at 39 deaths per 1,000 admissions. The top 4 States that contributed to the achievable benchmark are Alaska, Arizona, Michigan, and Rhode Island.
    • At the current rate of improvement, the 2012 benchmark could be met for the total population in approximately 2 years.
    • At current rates of improvement, uninsured patients could reach the 2012 benchmark in 7 years while other insurance groups could reach it in 2 years.

Inpatient Deaths

Inpatient deaths per 1,000 adult hospital admissions with heart attack, by residence location, 2000-2012

Chart shows inpatient deaths per 1,000 adult hospital admissions with heart attack, by residence location. Go to table below for details.

 

Residence Location 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Large Central Metropolitan 97.6 94.9 89.8 84.7 74.5 69.9 66.8 61.4 55.7 50.2 48.5 45.5 46.0
Large Fringe Metropolitan 97.9 93.4 88.2 80.4 74.7 66.8 66.0 61.2 56.2 50.1 48.6 47.9 43.8
Medium Metropolitan 100.4 99.1 89.1 80.5 78.3 74.4 66.3 61.3 54.7 51.0 45.7 48.0 48.8
Small Metropolitan 112.4 104.9 98.4 86.6 82.7 77.3 73.3 71.7 60.5 56.4 53.5 50.0 49.4
Micropolitan 110.3 101.7 97.3 96.0 92.5 87.9 79.6 74.8 61.7 59.0 54.5 49.6 51.6
Noncore 114.9 112.9 102.3 96.3 96.3 93.4 82.8 75.6 71.0 62.9 60.1 60.9 50.5

2012 Achievable Benchmark: 39 Deaths per 1,000 Admissions.

Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, Nationwide Inpatient Sample and AHRQ Quality Indicators, version 4.4, 2000-2012.
Denominator: Adults age 18 and over admitted to a non-Federal community hospital in the United States with acute myocardial infarction as principal discharge diagnosis.
Note: For this measure, lower rates are better. Rates are adjusted by age, major diagnostic category, all payer refined-diagnosis related group risk of mortality score, and transfers into the hospital.

  • Importance: Urban-rural disparities in cardiovascular mortality have been observed.
  • Trends: From 2000 to 2012, the risk-adjusted inpatient mortality rate for hospital admissions with heart attack decreased significantly for all residence location groups.
  • Groups With Disparities: In all years, residents of noncore areas had higher inpatient mortality rates for hospital admissions with heart attack than residents of large fringe metropolitan areas.
  • Achievable Benchmark:
    • The 2008 top 4 State achievable benchmark for inpatient heart attack mortality was 48 deaths per 1,000 admissions. By 2012, this benchmark had been attained overall and for residents of large central and large fringe metropolitan areas.
    • Because the 2008 benchmark was achieved by the total population, a new 2012 top 4 State achievable benchmark was set at 39 deaths per 1,000 admissions. The top 4 States that contributed to the achievable benchmark are Alaska, Arizona, Michigan, and Rhode Island.
    • At current rates of improvement, the 2012 benchmark could be met for the total population and all residence location groups in approximately 2 years.

Inpatient Deaths

Inpatient deaths per 1,000 adult hospital admissions with heart attack, by race/ethnicity, 2001-2012

Chart shows inpatient deaths per 1,000 adult hospital admissions with heart attack, by race/ethnicity. Go to table below for details

Year White Black API Hispanic
2001 98.7 92.2 89.5 97.2
2002 95.5 85.5 95.0 92.0
2003 86.9 81.6 84.2 86.6
2004 81.8 72.9 83.9 78.8
2005 76.9 65.2 75.0 75.2
2006 71.2 59.2 81.8 70.4
2007 65.4 55.8 71.1 63.6
2008 59.1 46.8 60.0 57.6
2009 53.7 46.1 57.5 57.5
2010 51.7 46.7 55.2 53.6
2011 50.5 42.1 55.0 48.1
2012 48.3 43.0 47.0 48.0

2012 Achievable Benchmark: 39 Deaths per 1,000 Admissions.

Key: API = Asian or Pacific Islander.
Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, State Inpatient Databases, disparities analysis files and AHRQ Quality Indicators, version 4.4, 2001-2012.
Denominator: Adults age 18 and over admitted to a non-Federal community hospital in the United States with acute myocardial infarction as principal discharge diagnosis.
Note: For this measure, lower rates are better. Rates are adjusted by age, major diagnostic category, all payer refined-diagnosis related group risk of mortality score, and transfers into the hospital. White and Black are non-Hispanic. Hispanic includes all races.

  • Importance: Racial disparities in heart attack care have been observed.
  • Trends: From 2001 to 2012, the risk-adjusted inpatient mortality rate for hospital admissions with heart attack decreased significantly for all racial/ethnic groups.
  • Groups With Disparities: In 2012, Black patients had lower inpatient mortality rates for hospital admissions with heart attack than White patients.
  • Achievable Benchmark:
    • The 2008 top 4 State achievable benchmark for inpatient heart attack mortality was 48 deaths per 1,000 admissions. By 2012, this benchmark had been attained for all racial/ethnic groups.
    • Because the 2008 benchmark was achieved by the total population, a new 2012 top 4 State achievable benchmark was set at 39 deaths per 1,000 admissions. The top 4 States that contributed to the achievable benchmark are Alaska, Arizona, Michigan, and Rhode Island.
    • At current rates of improvement, all racial/ethnic groups could reach the 2012 benchmark in approximately 2 years.

Return to Contents

Page last reviewed July 2015
Page originally created September 2015

The information on this page is archived and provided for reference purposes only.

 
AHRQ Advancing Excellence in Health Care