WBB's Thought Leadership

Quality Comparison between VA and Care in the Community

May 11

According to a recent RAND Corp. study, U.S. Department of Veterans Affairs (VA) medical facilities provide the same, if not better, care as non-VA hospitals.

WBB Take:  A common mistake by lay public, and even some healthcare workers, is to compare the highest-performing private sector medical facilities with the lowest-performing VA medical centers (VAMC). This results in broad opinion of the VA that is far worse than the reality, and in some cases leads to Veterans seeking help in the community rather than going to a VAMC that would give them better care, at lower cost, and with shorter waiting time.

For example, comparing the Mayo Clinic with Phoenix VAMC not only unfairly judges the other VAMCs, but also makes it more difficult for Veterans to have better service. The comparison hides the fact that quality in the community is often highly variable and will on average have inferior health outcomes to those at a VAMC. The comparison also hinders the industry from learning from VAMCs in fields in which VA excels, such as Primary Care and Mental Health integration, Polytrauma, Traumatic Brain Injury, and TeleHealth.

Additionally, it is important for the U.S. Department of Veterans Affairs to promote studies such as this to address stereotypes surrounding the quality of Veteran care. As healthcare evolves and VAMCs increase their ability to provide superior quality care, it is important that Veterans know of the tailored services provided by VA. As VAMCs improve performance, the Veteran population will see improved results that enable them to increase their participation in society and the workforce.
Cited by Matthew Loxton, Julia Davis, and Stephanie Owusu

Excerpt: “Veterans receive the same or better care at U.S. Department of Veterans Affairs (VA) medical facilities as patients at non-VA hospitals according to a recent RAND Corp. study.”

“’The RAND study adds to a growing list of research confirming what many Veterans and VA employees believe – VA provides high-quality care,” said VA Acting Secretary Robert Wilkie. “We are constantly striving to improve our care at VA, but this should encourage Veterans and the public that VA care is in many instances as good as or better than the private sector.”
“The study, which was published online April 25, compared each VA facility to three non-VA facilities with similar geographic settings (rural/urban,) size (number of beds) and complexity of care. The analysis focused on three of the six “Domains of Quality of Care” as defined by the Institute of Medicine, (now known as the National Academy of Medicine) including safety, effectiveness and patient-centered care.”

“The authors of the RAND study analyzed inpatient and outpatient performance measures used by VA and non-VA hospitals. On inpatient care, VA hospitals performed on average the same or significantly better than non-VA hospitals on 21 of 26 measures. VA performed significantly better than commercial and Medicaid Health Maintenance Organizations on 28 of 30 measures, with no difference on the other two. There was a wide variation in performance across VA, but an even wider variation among the non-VA hospitals.”

Source: VA Office of Public and Intergovernmental Affairs


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