Veterans Health Administration Hospitals Outperform Non–Veterans Health Administration Hospitals in Most Health Care Markets
Authors: William B. Weeks, Alan N. West
Journal: Annals of Internal Medicine (2018)

Letters19 March 2019Veterans Health Administration Hospitals Outperform Non–Veterans Health Administration Hospitals in Most Health Care MarketsWilliam B. Weeks, MD, PhD, MBA and Alan N. West, PhDWilliam B. Weeks, MD, PhD, MBAThe Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire (W.B.W.) and Alan N. West, PhDWhite River Junction VA Medical Center, White River Junction, Vermont (A.N.W.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-1540 SectionsSupplemental MaterialAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Recent studies have reported that health care provided by the Veterans Health Administration (VHA) is at least as good as that provided in the private sector (1–4). These studies tended to compare a representative sample of VHA patients or hospitals with a representative sample not in the VHA system, after adjusting for known differences that might cause misleading results. Several circumstances could explain these findings. The VHA may provide better care than the private sector in every local area. Alternatively, non-VHA care may be better than VHA care in more local areas but by a small amount, whereas VHA ...References1. O'Hanlon C, Huang C, Sloss E, Anhang Price R, Hussey P, Farmer C, et al. Comparing VA and non-VA quality of care: a systematic review. J Gen Intern Med. 2017;32:105-21. [PMID: 27422615] doi:10.1007/s11606-016-3775-2 CrossrefMedlineGoogle Scholar2. Blay E, DeLancey JO, Hewitt DB, Chung JW, Bilimoria KY. Initial public reporting of quality at Veterans Affairs vs non-Veterans Affairs hospitals. JAMA Intern Med. 2017;177:882-5. [PMID: 28418527] doi:10.1001/jamainternmed.2017.0605 CrossrefMedlineGoogle Scholar3. Nuti SV, Qin L, Rumsfeld JS, Ross JS, Masoudi FA, Normand SL, et al. 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. 2016;315:582-92. [PMID: 26864412] doi:10.1001/jama.2016.0278 CrossrefMedlineGoogle Scholar4. Anhang Price R, Sloss EM, Cefalu M, Farmer CM, Hussey PS. Comparing quality of care in Veterans Affairs and non-Veterans Affairs settings. J Gen Intern Med. 2018;33:1631-8. [PMID: 29696561] doi:10.1007/s11606-018-4433-7 CrossrefMedlineGoogle Scholar5. Rivard PE, Elixhauser A, Christiansen CL, Shibei Zhao , Rosen AK. Testing the association between patient safety indicators and hospital structural characteristics in VA and nonfederal hospitals. Med Care Res Rev. 2010;67:321-41. [PMID: 19880671] doi:10.1177/1077558709347378 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire (W.B.W.)White River Junction VA Medical Center, White River Junction, Vermont (A.N.W.)Note: Drs. Weeks and West were previously employed by the Veterans Health Administration. Some data used in this analysis were obtained from the The Dartmouth Atlas of Health Care, which is funded by the Robert Wood Johnson Foundation and the Dartmouth Clinical and Translational Science Institute under award UL1TR001086 from the National Center for Advancing Translational Sciences of the National Institutes of Health.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-1540.Reproducible Research Statement:Study protocol: See the Supplement. Statistical code: SPSS files (IBM) are available from Dr. Weeks (e-mail, [email protected]edu). Data set: See Table 1.This article was published at Annals.org on 11 December 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byEstimating Median Survival Following Hip Fracture Among Geriatric Females: (100 – Patient Age) ÷ 4National cross-sectional cohort study of the relationship between quality of mental healthcare and death by suicideComparing Postoperative Readmission Rates Between Veterans Receiving Total Knee Arthroplasty in the Veterans Health Administration Versus Community CareComparing Post-Acute Populations and Care in Veterans Affairs and Community Nursing HomesComparing Complication Rates After Elective Total Knee Arthroplasty Delivered Or Purchased By The VAThe Non-Veteran Experience at Veterans Affairs Medical Centers During the COVID-19 Pandemic: a Survey-Based StudyResearch translation for military and veteran health: research, practice, policyEliciting patient views on the allocation of limited healthcare resources: a deliberation on hepatitis C treatment in the Veterans Health AdministrationSame-Day Discharge After Outpatient PCI in a VA Hospital: Shared Decision Making and the VA MISSION ActA Comparison of Surgical Quality and Patient Satisfaction Indicators Between VA Hospitals and Hospitals Near VA HospitalsVA-Community Dual Care: Veteran and Clinician PerspectivesCompleting the MISSION: a Blueprint for Helping Veterans Make the Most of New ChoicesTrends in Preventative Health Services for Veterans with Military Coverage Compared to Non-Military CoverageMISSION Possible, but Incomplete: Pairing Better Access with Better Transitions in Veteran CareThe VA and Non-VA Experience of Tracking Good CareAssociation between PSA values and surveillance quality after prostate cancer surgeryImplications for Veterans' Health CareHealth Care Crisis by the Numbers 19 March 2019Volume 170, Issue 6Page: 426-428KeywordsDisclosureHealth careHealth care sectorHeart failureMedicarePatient advocacyResearch designSafetyVeteran care ePublished: 11 December 2018 Issue Published: 19 March 2019 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...