VA Cancer Care Rivals Private Sector Quality
- Patients received curative surgery for stage I or II non-small cell lung cancer and mediastinal evaluation, and chemotherapy and radiation for stage IIIA resected non-small cell lung cancer at the same rates as the private sector population.
- For prostate cancer, patients received androgen ablation within four months of diagnosis at similar rates. However patients with local or regional prostate cancer who under went external –beam radiation therapy were less likely than those in the private sector to receive 3-dimensional conformal radiation therapy or intensity modulated radiation therapy. Implementation of those expensive technologies was delayed in the VA system.
- Care was said to be better in the VHA system than in the private sector for patients with hematologic cancers, lymphoma and myeloma because patients had higher rates of chemotherapy regimen called CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone.)
"Our results provide encouraging support for the effectiveness of healthcare delivery, including specialized cancer care, for men in the VHA ...(and) suggest that the VHA system might serve as a model for care delivery as healthcare reform is implemented," wrote Keating, associate professor of medicine and of health care policy at Harvard Medical School and an associate physician at Brigham and Women's Hospital.
In an accompanying editorial, Joan J. Ryoo, MD of the UCLA Jonsson Comprehensive Cancer Center and Jennifer Malin, MD, of the Veterans Affairs Greater Los Angeles Healthcare System, suggested that the success of the VHA in cancer care should lead providers to more seriously consider the benefits of a single payer healthcare system.
"Despite the clamor of special interests, corporate lobbying and the particular American distaste for government run institutions, the public option may yet find its voice in the latest round of accomplishments demonstrated by the VHA," they wrote.
"The results of Keating and colleagues' analysis provide a poignant reminder that a vision for a national, integrated, government-run healthcare system not only exists but is, in fact, successful."
Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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