A VA study found that Veterans have better post-surgery outcomes than patients from private hospitals. Specifically, those who have non-cardiac surgery at VA hospitals are less likely to die 30 days later than patients treated in private hospitals.
Published in JAMA Surgery, the study found VA surgery patients had a 40% lower adjusted risk of 30-day mortality than in the private sector. It compared data from more than 4.6 million operations from Jan. 1, 2015, to Dec. 31, 2018.
The results “challenge the assumption that shifting care to the private sector can improve timeliness of surgical care without diminishing its quality,” according to the study.
These untested assumptions may have contributed to increasing Veteran access to private sector physicians and services through the Choice and MISSION acts, which give Veterans access to subsidized health care in the private sector.
Timeliness is only one aspect of high-value care
“If the private sector can provide equally high-quality care in a more timely fashion, that’s great,” said Dr. Paula K. Shireman, a study co-author from South Texas VA. “But timeliness is only one aspect of high-value care. The outcomes need to be good as well. These data put the burden of proof on those who assert that the private sector is as good or better than VA for providing surgical services and ensuring optimal surgical outcomes for Veterans.”
For frail and very frail patients, the risk of death within 30 days of surgery was even lower, “Suggesting that VA might be particularly adept at caring for such higher risk patients who represent a larger proportion of the patients treated by VA,” said another study co-author, Dr. Shipra Arya, from Palo Alto VA.
Integrated networks provide significant value to patients
VA is also uniquely positioned to care for Veterans’ additional needs, taking mental health, addiction treatment, transportation and housing into consideration when providing surgical care.
“VA’s wraparound services and integrated care networks provide significant value to my patients,” said senior author Dr. Daniel E. Hall, Pittsburgh VA surgeon and core investigator with VA’s Center for Health Equity Research and Promotion. “That might go a long way to explaining these findings.”
About Pittsburgh VA
Pittsburgh VA is one of the largest and most progressive VA health care systems in the nation. More than 4,000 employees serve nearly 80,000 Veterans every year, providing a range of services from complex transplant medicine to routine primary care. VAPHS is a leader in virtual care delivery through telehealth technology; a center of research and learning with 130 research investigators and $14.8 million in funding. We are a provider of state-of-the-art health care training to some 1,500 student trainees annually. Stay up to date at pittsburgh.va.gov, Facebook and Twitter.