Comparing the characteristics, utilization, efficiency, and outcomes of VA and NON-VA inpatient care provided to VA enrollees: A case study in New York

Medical Care

Volumn 46, Issue 8, 2008, Pages 863-871

  Weeks, William B ^a,b,c   West, Alan N ^a   Wallace, Amy E ^a,b,c   Fisher, Elliott S ^a,b,c  

^a VA MEDICAL CENTER   (United States)

^b DARTMOUTH INSTITUTE FOR HEALTH POLICY AND CLINICAL PRACTICE   (United States)

^c DARTMOUTH MEDICAL SCHOOL   (United States)

Author keywords

Health services utilization; Outcomes; VA Health Care System

Indexed keywords

AGED; ARTICLE; CASE STUDY; COMPARATIVE STUDY; DATA BASE; DEMOGRAPHY; ELDERLY CARE; FEMALE; HEALTH CARE SYSTEM; HEALTH CARE UTILIZATION; HOSPITAL ADMISSION; HOSPITAL PATIENT; HOSPITALIZATION; HUMAN; LENGTH OF STAY; MAJOR CLINICAL STUDY; MALE; OUTCOME ASSESSMENT; PATIENT CARE; RETROSPECTIVE STUDY; RURAL HEALTH CARE; UNITED STATES; VETERAN; HEALTH SERVICE; MIDDLE AGED; PUBLIC HOSPITAL; REGISTER; STATISTICS; UTILIZATION REVIEW;

AGED; HEALTH SERVICES; HOSPITALIZATION; HOSPITALS, VETERANS; HUMANS; MALE; MIDDLE AGED; NEW YORK; REGISTRIES; RETROSPECTIVE STUDIES; VETERANS;

EID: 49649089516     PISSN: 00257079     EISSN: None     Source Type: Journal    
DOI: 10.1097/MLR.0b013e31817d92e1     Document Type: Article

References (39)

1. Kizer K. Prescription for Change. Washington, DC: Department of Veterans Affairs; 1996
2. Jha AK, Perlin JB, Kizer KW, et al. Effect of the transformation of the Veterans Affairs Health Care System on the quality of care. N Engl J Med. 2003;348:2218-2227
3. Kerr E, Gerzoff RB, Krein SL, et al. Diabetes Care Quality in the Veterans Affairs Health Care System and Commercial Managed Care: the TRIAD Study. Ann Intern Med. 2004;141:272-281
4. Oliver A. The Veterans Health Administration: an American success story? Milbank Quart. 2007;85:5-35
5. Waller D. How VA hospitals became the best. Time. 2006;168:36-37
6. Hynes DM, Kolling K, Stroupe K, et al. Veterans' access to and use of Medicare and Veterans Affairs health care. Med Care. 2007;45:214-223
7. Weeks WB, Mahar PJ, Wright SM. Utilization of VA and Medicare services by Medicare-eligible veterans in Northern New England: the impact of additional access points in a rural setting. J Health C Manag. 2005;50:95-106
8. Wright SM, Daley J, Fisher ES, et al. Where do elderly veterans obtain care for acute myocardial infarction: Department of Veterans Affairs or Medicare? Health Serv Res. 1997;31:739-754
9. Wright SM, Petersen LA, Lamkin RP, et al. Increasing use of Medicare services by veterans with acute myocardial infarction. Med Care. 1999; 37:529 -537
10. VA Information Resource Center. Information on VA-Medicare data. Available at: http://www.virec.research.va.gov/DataSourcesName/VA- MedicareData/Cohort.htm. Accessed March 15, 2007
11. 1. Fisher ES, Welch HG. The future of the Department of Veterans Affairs health care system. JAMA. 1995;273:651-655
12. Borowsky SJ, Cowper DC. Dual use of VA and non-VA primary care. J Gen Intern Med. 1999;14:274-280
13. Shen Y, Hendricks A, Zhang S, et al. VHA enrollees' health care coverage and use of care. Med Care Res Rev. 2003;60:253-267
14. National Center for Health Statistics. Health, United States 2004. Table 132. Hyattsville, MD: National Center for Health Statistics; 2004
15. Enrollment-provision of hospital and outpatient care to veterans-VA. Proposed rule. Fed Regist. 1998;63:37299-37307
16. Weeks WB, Bott DM, Lamkin RP, et al. Veterans Health Administration and Medicare outpatient health care utilization by older rural and urban New England veterans. J Rural Health. 2005;21:65-69
17. Weeks WB, Bazos DA, Bott DM, et al. New York's statistical model accurately predicts mortality risk for veterans who obtain private sector CABG. Health Serv Res. 2005;40:1186-1196
18. Long JA, Bamba MI, Ling B, et al. Missing race/ethnicity data in Veterans Health Administration based disparities research: a systematic review. J Health Care Poor Underserved. 2006;17:128 -140
19. Sohn MW, Zhang H, Arnold N, et al. Transition to the new race/ ethnicity data collection standards in the Department of Veterans Affairs. Popul Health Metr. 2006;6:1-10
20. ZIP Code RUCA approximation methodology. 2004. Available at: http://www.fammed.washington.edu/wwamirhrc/. Accessed March 17, 2004
21. Washington State Department of Health-Guidelines for Using Rural/ Urban Classifications. Table 3: Four-tiered consolidation of RUCA codes. 2004. Available at: http://www.doh.wa.gov/Data/guidelines/ RuralUrban.htm#Ruca. Accessed November 24, 2004
22. Charlson M, Pompei P, Ales K, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373-383
23. Deyo RA, Cherkin DC, Ciol MA. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol. 1992;45:613-619
24. Rivard P, Elwy R, Loeveland S. Applying patient safety indicators (PSIs) across healthcare systems: achieving data comparability. In: Battles JB, Marks ES, Lewin DI, et al, eds. Advances in Patient Safety: From Research to Implementation. Rockville, MD: Agency for Healthcare Research and Quality and Department of Defense; 2005:7-26
25. Wagner TH, Chen S, Barnett PG. Using average cost methods to estimate encounter-level costs for medical-surgical stays in the VA. Med Care Res Rev. 2003;60:15S-36S
26. DRG Expert: A Comprehensive Guidebook to the Drug Classification System. Eden Prairie, MN: Ingenix; 2002
27. Ashton C, Ded Junco D, Souchek J, et al. The association between the quality of inpatient care and early readmission: a meta-analysis of the evidence. Med Care. 1997;35:1044-1059
28. Durbin J, Lin E, Layne C, et al. Is readmission a valid indicator of the quality of inpatient psychiatric care? JBehav Health Serv Res. 2007;34:137-150
29. Iglehart JK. The mental health maze: some progress, many pitfalls. Health Aff. 2006;25:599
30. 0. Wallace AE, West AN, Booth BM, et al. Unintended consequences of regionalizing specialized VA addiction services. Psychiatr Serv. 2007; 58:668-674
31. Wilson NJ, Kizer KW. The VA health care system: an unrecognized national safety net. Health Aff (Millwood). 1997;16:200-204
32. 2. Fisher ES, Welch HG. Avoiding the unintended consequences of growth in medical care: how might more be worse? JAMA. 1999;281:446 -453
33. Lynch J, Kaplan G. Socioeconomic position. In: Berkman LF, Kawachi I, eds. Social Epidemiology. New York, NY: Oxford University Press; 2000
34. Medical Expenditure Panel Survey. Available at: http://www.meps.ahrq.gov/ mepsweb/. Accessed July 24, 2007
35. Behavioral risk factor surveillance system. Available at: http://www.cdc.gov/brfss/.Accessed July 24, 2007
36. Weeks WB, West AN. Where do VA patients obtain heart, liver, and kidney transplants? Military Med. 2007;172:1154-1159
37. West AN, Weeks WB. Who pays when VA users are hospitalized in the private sector? Evidence from three data sources. Med Care. 2007;45:1003-1007
38. Burgess JF Jr, DeFiore DA. The effect of distance to VA facilities on the choice and level of utilization of VA outpatient services. Soc Sci Med. 1994;39:95-104
39. West AN, Weeks WB, Wright SM, et al. When VA patients have non-VA hospitalizations, who pays for what services, and what are the research implications? A New York case study. Med Care. 2008;46:872-877