This study will be helpful to use as a comparator as it is one of the last studies published with the latest pre-MISSION Act data. 3 Even at the level of individual pairs, a majority of VA centers performed similarly to or better than their comparator on all quality measures except for one clinical measure. This study reinforces the findings of previous RAND Corporation research comparing VA and non-VA medical centers in that the data do not necessarily mirror public perception of a universally troubled VA system. At the pairwise level, VA medical centers performed the same as or better than the mean of the total sample than non-VA medical centers for each measure except for IMM-2, although three measures (PSI 04, CAUTI, and MRSA) were missing more than half of the pairwise data.In aggregate, no significant differences were found between VA and non-VA medical centers on measures of CAUTI, MRSA, and HCAHPS #19.In aggregate, non-VA medical centers fared significantly better than VA medical centers on measures of IMM-2 and HCAHPS #18.In aggregate, Veterans Affairs medical centers fared significantly better than non-VA medical centers on PSI 04 and CTM-3.This report details the findings of the study, including: VA medical centers were compared to non-VA hospitals on four clinical quality indicators: IMM-2 (influenza vaccination), PSI 04 (preventable surgical deaths), CAUTI (catheter-associated urinary tract infections), and MRSA (methicillin-resistant Staphylococcus aureus) infection and three patient experience quality indicators: CTM-3 (care transition), HCAHPS #18 (overall hospital rating, as measured in the Hospital Consumer Assessment of Healthcare Providers and Systems), and HCAHPS #19 (would recommend hospital). Variables used to select comparators included bed size, 2 rurality, ownership, proximity, and teaching status. One nearby comparator hospital was identified for each VA medical center in the United States with sufficient information for comparison (n = 125 pairs). The link to the state-level data can be found on the Measuring Communities website. In addition to this working paper, analysis from this study will be published in MFRI’s Measuring Communities database to provide military and veteran-serving organizations with a better assessment of VA medical care in their communities, and to paint a picture of VA clinical and quality outcomes using the last data set released pre-MISSION Act. This research partnership sought to establish 1-to-1 comparisons of care quality in VA and nearby comparable non-VA medical centers with the goal of providing veterans and veteran organizations with an accurate picture of VA medical services in their area. The Military, Veterans, and Society program at CNAS addresses issues faced by military, veterans, and their families. MFRI conducts research and outreach for those who serve military and veteran families, with specific programming centered on veteran health. This study is the result of a partnership between the Military Family Research Institute (MFRI) at Purdue University and the Center for a New American Security (CNAS).
With VA system advocates fearing a move away from VA care and toward privatization under the MISSION Act, further analysis is needed to determine how the VA fares in terms of clinical and patient experience quality. Previous research comparing VA and non-VA quality and clinical data, including reports of patient experiences, shows that generalizations cannot be made as to which system provides the best and safest services.
An already-identified rise in the number of veterans seeking care since implementation necessitates a new approach to assisting veterans in their health care decisions. Veterans now qualify for non-Veterans Affairs (VA) medical care based on a new set of criteria, including VA wait times for appointments (more than 20 days) and drive time to access VA care (more than 30 minutes).
Implementation of the Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act of 2018 is anticipated to result in expanded access for veterans seeking medical care. Renewing the National Security Consensus.Enhancing DHS Oversight & Accountability.Constructing Regional Partnerships and Seizing Emerging Opportunities.
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