Validity of acute myocardial infarction inpatient process measures on the report card in Taiwan

Objectives: To investigate the validity of acute myocardial infarction (AMI) process measures on the public report card in Taiwan. If the quality measure of report card is highly valid, then it can enhance confidence over the use of report cards by citizens, and physicians would be more willing to make improvements based on the results of performance. Methods: The study analyzes the associations between the 5 process measures reported and the negative outcome measures from 2011 to 2012. Subjects were selected from the National Health Insurance Association (NHIA) admission files and had a principal diagnosis of acute AMI (ICD-9-CM 410) during the study period. The main outcome measures include return to the emergency department (ED) within 3 days, unscheduled readmission within 14 days, and 30-day mortality at the patient and hospital levels. Results: Four process measures are all negatively associated with the outcomes at hospital level, except for the LDL examination. Conclusions: Regarding the requirement for validity transparency of a report card, our research suggests that these process measures currently used on the AMI report card in Taiwan are valid based on their associations with negative outcomes. In other words, a hospital that achieves high scores on process measures probably also realizes better outcome quality. (Taiwan J Public Health. 2019;38(3):289-300).