Regulatory relationships of demographic, clinical characteristics and quality of care for heart failure patients in southern China

OBJECTIVE: Quality of care for Chinese patients with heart failure was substandard. This study aimed to ascertain the characteristics related to quality of care to narrow the gap. METHODS: Data from 2064 heart failure patients between 1 January 2012 and 31 December 2015 at a hospital in Fujian Province were analyzed. The Bayesian network was used to assess the regulatory relationships between demographic and clinical characteristics and compliance with quality indicators. RESULTS: The compliance with quality indicators ranged from 42.5% to 90.2%. The compliance with recommended doses for medications all reached or was close to 100% except indapamide. Residence place, hypertension, troponin, B-type natriuretic peptide, heart rate, lung disease, number of emergency treatments (ETs) and ejection fraction directly regulated the compliance, and gender, age, medical payment methods, myocardiopathy, coronary heart disease and arrhythmia indirectly regulated the compliance in the Bayesian network. The lower compliance was found in patients under ET, patients with abnormal testing indicators, patients without specific comorbidities and patients under the New Rural Cooperative Medical Scheme or self-paying. Patients with lung disease and those who lived in urban areas had a longer length of stay. CONCLUSIONS: The compliance with medication indicators for heart failure was suboptimal, but recommended doses were prescribed to patients who received medications. A series of strategies should be developed to improve the quality of care, such as expanding the scope and depth of knowledge of guidelines and clinical pathways, integrating the reminder and quality assessment model into the hospital medical record information system, paying more attention to the vulnerable population and improving the medical security system.