[Assessment of quality of care in heart failure].

OBJECTIVES: To evaluate the presence of predetermined quality aspects in the management of hearth failure inside an Internal Medicine Department.

METHODS: Prospective study under protocol of 200 patients admitted to our Internal Medicine Department under diagnosis of hearth failure from july 97 to july 98.

RESULTS: Every patient of our study had an anamnesis, physical examination, chest radiology and electrocardiography. Only 42.4% had an electrocardiography. Hearth failure etiology was determined in only 62.6% (30% isquemic, 22% hypertensive, 6% mixed, 30% valvulopathy, 9% specific myocardiopathy, 3% others). 47.5% of the patients were functionally classified after NYHA (I 2.7%, II 58%, III 35.4%, IV 3.6%). Treatment and drug dosing were adequate in 85.5% (diuretics 91%, ACEI 42%, digitalis 36%, nitrates 56%, inotropic drugs 2%, betablockers and calcium antagonists 1%). 13% of the patients were admitted to the hospital more than three times a year. Mortality rate was 18% and 19% of them were older than 70 years old.

CONCLUSIONS: Quality management indicators were acceptably present in our study. We must insist on etiologic diagnosis and NYHA classification as a way of improving care.