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VA touts new study on its health care, but data raise questions

WASHINGTON — The Department of Veterans Affairs has for years touted the achievements of its health care system, but a new study shows that its health outcomes are . . . about like everybody else's.

The VA highlighted the study, published in the journal Medical Care, saying in a press release this week that "VA Health System Shines in Quality-of-Care Study."

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

However, the study, which synthesized the results of three dozen other studies that compared VA health care to care provided by non-VA providers, concluded that the VA performed well on many measures of medical care, but also found that the VA had little impact on the key question of whether the patient lived or died.

Moreover, most of the research the study depended on to reach its conclusions dates to when Bill Clinton was president. One source for the study is dated 1991, when George H.W. Bush was in the White House.

What the latest study shows is that the VA performs well on what are known as "process" measures — whether a certain test was ordered, for example. But studies that compare health outcomes — do patients in the VA system do better or live longer? — are equivocal.

Of 12 studies that compared mortality, for example, three showed a better outcome for VA patients, two showed a better outcome for non-VA patients, and seven showed no difference.

That's very different from the process measures, which showed an overwhelming VA advantage.

Researchers aren't sure what causes that disconnect. If veterans are taking their drugs and getting their tests done, the thinking goes, they should be living longer. But for the most part, the data don't show that.

"When it comes to mortality, we found that the VA does no better and does no worse," said study author Amal Trivedi, an investigator at a VA medical center in Providence, R.I.

It would be helpful to study other health outcomes — so-called "intermediate outcomes" that detail health status short of death — but those aren't often measured, Trivedi said.

There were some other caveats to the study. One is what's known as a "publication bias," since most of the studies researchers found were funded by the VA. But researchers weren't sure why that would show a VA advantage on process measure but not one on outcomes.

The lack of fresh data was a central problem with the study, Trivedi said.

VA touts new study on its health care, but data raise questions 11/12/10 [Last modified: Monday, November 7, 2011 1:21pm]
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