Faculty Collaboration Database

Are patients at Veterans Affairs medical centers sicker? A comparative analysis of health status and medical resource use. Arch Intern Med 2000 Nov 27;160(21):3252-7

Date

11/23/2000

Pubmed ID

11088086

DOI

10.1001/archinte.160.21.3252

Scopus ID

2-s2.0-0034722752 (requires institutional sign-in at Scopus site)   663 Citations

Abstract

BACKGROUND: The Veterans Affairs (VA) health system has been criticized for being inefficient based on comparisons of VA care with non-VA care. Whether such comparisons are biased by differences between the VA patient population and the non-VA patient population is not known. Our objective is to determine if VA patients are different from non-VA patients in terms of health status and medical resource use.

METHOD: We analyzed 128,099 records from the National Health Interview Survey for the years 1993 and 1994. We compared the VA patient population with the general patient population for self report on health status, number of medical conditions, number of outpatient physician visits, number of hospital admissions, and number of hospital days each year.

RESULTS: The VA patient population had poorer health status (odds ratio [OR], 14.7; 95% confidence interval [CI], 10.7-20.2), more medical conditions (OR, 14; 95% CI, 10.5-18.7), and higher medical resource use compared with the general patient population (OR, 3.7 for 3 or more physician visits per year; OR 5.4 for 3 or more hospital admissions per year; OR, 7.7 for 21 or more days spent in a hospital per year). However, after controlling for health and sociodemographic differences, VA patients had similar resource use compared with the general patient population.

CONCLUSION: Large differences in sociodemographic status, health status, and subsequent resource use exist between the VA and the general patient population. Therefore, comparisons of VA care with non-VA care need to take these differences into account. Furthermore, health care planning and resource allocation within the VA should not be based on data extrapolated from non-VA patient populations. Arch Intern Med. 2000;160:3252-3257.

Author List

Agha Z, Lofgren RP, VanRuiswyk JV, Layde PM

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Female
Health Care Surveys
Health Resources
Health Services Accessibility
Health Status Indicators
Health Surveys
Hospitals, Veterans
Humans
Male
Middle Aged
Multivariate Analysis
Socioeconomic Factors
United States
Veterans