VA Health System Shines in Quality-of-Care Study

WASHINGTON — A report in the November issue of the national publication Medical Care finds that the Department of Veterans Affairs (VA) health system generally outperforms the private sector in following recommended processes for patient care.

“This report is strong evidence of the advancements VA continues to make in improving health care over the past 15 years,” said Secretary of Veterans Affairs Eric K. Shinseki.  “The systems and quality-improvement measures VA actively uses are second to none, and the results speak for themselves.”

A research team with VA, RAND Corp. (a non-profit research institution) and two universities reviewed 36 studies published between 1990 and 2009.  While the review did not include studies of surgical care, it did cover a range of studies of diseases common among Veterans, such as diabetes, heart disease and depression.

The study authors, led by Dr. Amal Trivedi of the Providence, R.I., VA Medical Center and Brown University, cite possible reasons for VA’s more positive performance, including integration of health care settings, use of performance measures with an accountability framework, disease-management practices and electronic medical record or health information technology.  Among the specific findings of the review were:

• Nine studies comparing VA and non-VA care in general showed greater adherence to accepted processes of care—or better health outcomes—in VA.
• Five studies of mortality following a heart attack or other coronary event found similar survival rates in VA and non-VA settings.
• Three studies of care after a heart attack found greater rates of evidence-based drug therapy in VA; one found lower use of clinically appropriate angiography (blood vessel imaging) in VA.
• Three studies of diabetes care found VA to have better adherence to guidelines.
• Three studies found higher rates of vaccination against flu and pneumonia for the elderly in VA.

To gain greater insight into differences between VA and non-VA care and to also identify ways to improve VA care even further, the authors recommend continuing research with even more recent data. They also say there’s a need for studies that compare VA specifically to high-performing private health care systems, rather than to a broad cross section of non-VA facilities.

Collaborating with Trivedi on the review were co-authors affiliated with RAND, the University of California-Los Angeles and the Greater Los Angeles VA Medical Center.

For more information about VA health care, visit www.va.gov/health. To learn more about VA research, go to www.research.va.gov.