The use of ACE inhibitors in the treatment of heart failure in Kentucky Medicare beneficiaries: a quality improvement project.

Heart failure (HF) is a highly prevalent and frequently fatal condition. During 1998, 10,815 Medicare beneficiaries in Kentucky were diagnosed as having HF; 14,777 beneficiaries were hospitalized for the condition, and 696 Medicare beneficiaries died with HF as the primary diagnosis. Proper diagnosis and subsequent treatment with angiotensin converting enzyme (ACE) inhibitors improve functional status, quality of life, and survival among HF patients. Health Care Excel, Incorporated (HCE), the Medicare Quality Improvement Organization for Kentucky, collaborated with a select group of Kentucky hospitals to conduct an HF quality improvement project. The improved pharmacotherapy by these hospitals is presented and discussed. The use of ACE inhibitors improved from 54.1% to 66.0% and the use of either ACE inhibitors or angiotensin II receptor blockers (ARBs) to 72.1%.