The Cardiovascular Outcomes Research Center at Yale University will focus on research to promote hospital and regional excellence in patient outcomes and healthcare value. To accomplish this, the Yale team will leverage its expertise with the Centers for Medicare &Medicaid Services (CMS) outcomes measures;extend its pioneering work in positive deviance research and mixed methods approaches;build upon its longstanding collaborations with top outcomes researchers throughout the country;and engage with individuals and organizations capable of transforming the products of the research into practice. We will pursue two related research projects, and will leverage the Center to promote inter-institutional collaboration and the development of early stage investigators. Project 1 aims are: To characterize hospital and Hospital Referral Region (HRR) performance, assess time trends, and determine factors associated with performance and improvement, defined by the CMS publicly reported measures for acute myocardial infarction (AMI), heart failure (HF), percutaneous coronary intervention (PCI), and internal cardioverter defibrillators (ICD);to investigate hospital and regional performance using novel measures that focus on a longer episode of care (1-year mortality measures for patients hospitalized with AMI and HF) and population-based hospitalization rates (HRR hospitalization rates for AMI and HF);to characterize the costs of care for AMI and HF during the index hospitalization, in the first 30 days, and 1 year after admission;and investigate how costs and payments relate to hospital and regional performance (30-day and 1-year risk-standardized mortality and 30- day eadmission). Project 2 aims are: To develop hypotheses concerning the hospital organizational strategies associated with exceptionally low hospital-level risk-standardized 30-day mortality and readmission rates for patients undergoing PCI;and to survey hospitals in order to test hypotheses about which specific hospital organizational strategies are associated with better performance on these PCI outcomes. This project will involve a partnership with the American College of Cardiology's National Cardiovascular Data Registry, and will elucidate the organizational and clinical strategies associated with the best hospital performance for PCI patients. Together, these studies will respond to the need for evidence to guide efforts to improve care and better understand how to shift the curve of performance at the hospital and regional level toward better outcomes.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Project--Cooperative Agreements (U01)
Project #
Application #
Study Section
Special Emphasis Panel (ZHL1-CSR-J (S1))
Program Officer
Bonds, Denise
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Yale University
Internal Medicine/Medicine
Schools of Medicine
New Haven
United States
Zip Code
Zheng, Xin; Curtis, Jeptha P; Hu, Shuang et al. (2016) Coronary Catheterization and Percutaneous Coronary Intervention in China: 10-Year Results From the China PEACE-Retrospective CathPCI Study. JAMA Intern Med 176:512-21
Bucholz, Emily M; Butala, Neel M; Normand, Sharon-Lise T et al. (2016) Association of Guideline-Based Admission Treatments and Life Expectancy After Myocardial Infarction in Elderly Medicare Beneficiaries. J Am Coll Cardiol 67:2378-91
Nuti, Sudhakar V; Qin, Li; Rumsfeld, John S et al. (2016) Association of Admission to Veterans Affairs Hospitals vs Non-Veterans Affairs Hospitals With Mortality and Readmission Rates Among Older Men Hospitalized With Acute Myocardial Infarction, Heart Failure, or Pneumonia. JAMA 315:582-92
Dharmarajan, Kumar; Strait, Kelly M; Tinetti, Mary E et al. (2016) Treatment for Multiple Acute Cardiopulmonary Conditions in Older Adults Hospitalized with Pneumonia, Chronic Obstructive Pulmonary Disease, or Heart Failure. J Am Geriatr Soc 64:1574-82
Bucholz, Emily M; Beckman, Adam L; Kiefe, Catarina I et al. (2016) Smoking status and life expectancy after acute myocardial infarction in the elderly. Heart 102:133-9
Dreyer, Rachel P; Xu, Xiao; Zhang, Weiwei et al. (2016) Return to Work After Acute Myocardial Infarction: Comparison Between Young Women and Men. Circ Cardiovasc Qual Outcomes 9:S45-52
Dreyer, Rachel P; Smolderen, Kim G; Strait, Kelly M et al. (2016) Gender differences in pre-event health status of young patients with acute myocardial infarction: A VIRGO study analysis. Eur Heart J Acute Cardiovasc Care 5:43-54
Li, Xi; Li, Jing; Masoudi, Frederick A et al. (2016) China PEACE risk estimation tool for in-hospital death from acute myocardial infarction: an early risk classification tree for decisions about fibrinolytic therapy. BMJ Open 6:e013355
Bucholz, Emily M; Butala, Neel M; Ma, Shuangge et al. (2016) Life Expectancy after Myocardial Infarction, According to Hospital Performance. N Engl J Med 375:1332-1342
Downing, Nicholas S; Shah, Nilay D; Neiman, Joseph H et al. (2016) Participation of the elderly, women, and minorities in pivotal trials supporting 2011-2013 U.S. Food and Drug Administration approvals. Trials 17:199

Showing the most recent 10 out of 233 publications