VA Cancer Care Rivals Private Sector Quality
A major revamping of Veterans Health Administration care for more than six million Americans in the 1990s corrected many problems in the then "dysfunctional" system. And since then, research has documented that the VA's major improvements in preventive and long-term care, and for care for several acute and chronic conditions, has made the system at least as good as the private sector, and in some cases better.
But data have been lacking for cancer care. A study in Monday's Annals of Internal Medicine has found that process improvements in care for colorectal, lung or prostate cancer, or lymphoma or multiple myeloma are now "similar to or better than care for fee-for-service Medicare beneficiaries."
However adoption of some expensive technologies to treat prostate cancer, such as three-dimensional conformal radiotherapy or intensity modulated radiation therapy, have tended to lag.
The report was prepared by Nancy L. Keating, MD and colleagues at Harvard Medical School and was funded by the Department of Veterans Affairs. It covered male patients over age 65 who were treated between 2001 and 2004 in both the VA system in all parts of the country and compared them with data collected for fee-for-service Medicare beneficiaries and followed them through 2005.
The VA, which treats 6.1 million patients, is the largest integrated healthcare system in the country. So outcomes from its care procedures and policies can inform other providers, the researchers say.
Among the report's findings:
- Patients in the VHA system with colon and rectal cancer received the diagnosis at earlier stages than those in the private sector, although rates of unstaged colorectal cancer were also higher in the VHA population.