A new study provides a rare example of something akin to a head-to-head comparison of the quality of care delivered at hospitals run by the Veterans Administration (VA) versus those outside this federal system.
In this case, the advantage appears to go to the VA on a measure of how likely patients were to remain alive within a month of being treated with emergency care.
This study focuses on veterans aged 65 years or older who were enrolled in both the Veterans Health Administration and the Medicare program, reported David C. Chan, M.D., Ph.D., of Stanford University and co-authors in a paper published by the BMJ on Feb. 16. (This paper is available under open-access terms, making it freely accessible to the public.)
Chan and co-authors focused on cases of medical crises involving emergency ambulance rides with lights and sirens that originated from 911 dispatch calls. They used data from the VA, Medicare and Social Security Administration to track what happened to these veterans in the 30 days following these episodes. They also honed in on cases involving veterans who lived within 20 miles of at least one VA hospital and at least one other kind of hospital.
There were 9.32 deaths per 100 patients in those seen at the VA hospitals, Chan and co-authors wrote. They reported a 95% confidence interval range of 9.15 to 9.50 for this figure. (For more on understanding confidence intervals, check the glossary in AHCJ’s medical studies section.) For the veterans taken to other hospitals, Chan and co-authors estimated a rate of 11.67 deaths per 100 patients. They cited a 95% confidence interval range of 11.58 to 11.76 for this group.
These differences translate into an adjusted mortality rate after 30 days that was 20.1% lower among veterans taken to VA hospitals by ambulances than among veterans taken to other hospitals, Chan and co-authors wrote.