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Beleaguered VA Delivers Better Care Than Your Hospital

By John Commins  
   April 26, 2018

A RAND study found the VA health system performed as well or significantly better than non-VA hospitals on key measures for inpatient and outpatient safety and care effectiveness.

Despite its many, well-publicized problems, the VA delivers as good or better healthcare than non-VA systems on most measures of inpatient and outpatient care quality, albeit with wide variations across individual VA hospitals, a RAND Corporation study says.

Researchers examined common healthcare quality measures and found that VA hospitals generally provided better quality care than non-VA hospitals and the VA's outpatient services were better quality when compared to commercial HMOs, Medicaid HMOs and Medicare HMOs.

"Consistent with previous studies, our analysis found that the VA healthcare system generally provides care that is higher in quality than what is offered elsewhere in communities across the nation," said study lead author Rebecca Anhang Price, a senior policy researcher at RAND. 

The study found wide variation in the quality of care provided in VA hospitals, but the variation is smaller than what researchers observed among non-VA hospitals.

For each of the VA's 135 hospitals, RAND identified three non-VA hospitals that had similar characteristics, such as geographic location. The performance of VA hospitals was compared to similar non-VA hospitals, as well as health systems overall.

The information analyzed includes the Healthcare Effectiveness Data and Information Set, and the Survey of Healthcare Experiences of Veterans.

The study found that:

  • VA hospitals performed the same or better than non-VA hospitals on all six measures of inpatient safety, all three measures of inpatient mortality and 12 measures of the effectiveness of inpatient care.
  • VA hospitals performed worse on three readmission measures and two effectiveness measures.
  • VA inpatient performance was lower on the patient experience measure for pain management, while performance of VA hospitals was higher on patient experiences for management of care transitions.

John Commins is a senior editor at HealthLeaders.

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