Tag Archives: va hospitals

Study suggests veterans are more likely to survive after receiving emergency care at VA hospitals

Photo by Pavel Danilyuk via Pexels.

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.

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Philly VA doc defends himself before Congress

The New York Times‘ Walt Bogdanich has followed up his investigation into a “rogue” cancer unit at a Philadelphia VA hospital with a report on the questioning of one of the alleged rogue doctors, Gary Kao, at a congressional panel headed by Pennsylvania Sen. Arlen Specter. Kao defended himself by claiming that the mistakes he made during a process called brachytherapy (in which tiny radioactive seeds are inserted into a patient’s prostate) were nothing out of the ordinary.

Dr. Kao did not deny placing large numbers of seeds outside the prostate, but he said investigators were wrong to single him out. “It’s a recognized risk of the procedure,” he told the panel.

Dr. Kao’s assertion was disputed by Steven A. Reynolds, who oversees materials safety at the N.R.C., which regulates all nuclear materials. Cases where large numbers of seeds miss the prostate, Mr. Reynolds said, “happen very, very infrequently.”

Kao said he voluntarily appeared before the panel to set the record straight and correct what he called “very serious false allegations” made by Bogdanich’s initial article.

VA: Consent forms for human studies incomplete

According to a report released by the Department of Veterans Affairs Office of Inspector General, an audit of representative VA hospitals found that about 31 percent of informed consent documentation for human studies was incomplete. In the vast majority (97 percent) of cases, this was due to lack of a witness signature.

Among the report’s other findings:

  • An estimated 1 percent (1,023) of the 110,231 non-compliant lacked the subject’s signature or that of their authorized representative, rendering them legally ineffective.
  • An estimated 1.7 percent of the 367,103 consent forms could not be located, the report extrapolated the national range to be somewhere between 0.6 percent and 4.5 percent.
  • In specific situations, Institutional Review Boards can waive informed consent. In two of the 33 such cases examined, sufficient documentation of this waiver was not found.