Administrative Memos

200207

FROM: Theodore O. Will, Chief Executive Officer
DATE: Jul 18, 2002
SUBJECT: Stroke Prevention in Atrial Fibrillation (AF) in New York State Medicare Patients
IPRO CONTACTS:

Patricia Gagliano, M.D., Clinical Coordinator, x-547 - Project Leader
Monte Malach, M.D., F.A.C.C., M.A.C.P., Clinical Coordinator, x-634
Marguerite Shaffer, R.N., C.P.H.Q., Director, Downstate Improvement Strategies, x-634

Enclosed please find a statewide report on Stroke Prevention in Atrial Fibrillation in New York State Medicare Patients. The purpose of this quality improvement project is to increase utilization of warfarin in eligible Medicare patients with atrial fibrillation and no contraindications.

IPRO has been working with physicians, providers and other health care personnel since 1994 to improve the use of anticoagulation therapy for eligible patients with atrial fibrillation. Although there has been improvement over the years, there still remains a significant number of patients who are not discharged on warfarin and have no documented contraindications.

A random sample of 750 cases with a principal or secondary diagnosis of atrial fibrillation was selected and the results demonstrated that 61.9% of eligible Medicare patients, who had no contraindications, were discharged on warfarin therapy. This represents an increase from the baseline rate of 54.8%.

The top fifty high volume providers and their affiliated institutions, (sharing the same Medicare provider number) discharging patients with a principal or secondary diagnosis of atrial fibrillation will receive a hospital-specific remeasurement report. It is important to note that the dates for the baseline and remeasurement will be different than those in the Centers for Medicaid & Medicare Services' statewide random samples.

Enclosed is a fax order form for stroke prevention educational materials (including AF), as well as a pocket card with recommendations based on the Sixth ACCP Consensus Conference on Antithrombotic Therapy for non-valvular AF. Should you have any questions or need assistance with the implementation of a quality improvement program, please feel free to call one of the above-mentioned contacts.