| Title |
Comparing Quality of Care in Veterans Affairs and Non-Veterans Affairs Settings
|
|---|---|
| Published in |
Journal of General Internal Medicine, April 2018
|
| DOI | 10.1007/s11606-018-4433-7 |
| Pubmed ID | |
| Authors |
Rebecca Anhang Price, Elizabeth M. Sloss, Matthew Cefalu, Carrie M. Farmer, Peter S. Hussey |
| Abstract |
Congress, veterans' groups, and the press have expressed concerns that access to care and quality of care in Department of Veterans Affairs (VA) settings are inferior to access and quality in non-VA settings. To assess quality of outpatient and inpatient care in VA at the national level and facility level and to compare performance between VA and non-VA settings using recent performance measure data. We assessed Patient Safety Indicators (PSIs), 30-day risk-standardized mortality and readmission measures, and ORYX measures for inpatient safety and effectiveness; Healthcare Effectiveness Data and Information Set (HEDIS®) measures for outpatient effectiveness; and Consumer Assessment of Healthcare Providers and Systems Hospital Survey (HCAHPS) and Survey of Healthcare Experiences of Patients (SHEP) survey measures for inpatient patient-centeredness. For inpatient care, we used propensity score matching to identify a subset of non-VA hospitals that were comparable to VA hospitals. VA hospitals performed on average the same as or significantly better than non-VA hospitals on all six measures of inpatient safety, all three inpatient mortality measures, and 12 inpatient effectiveness measures, but significantly worse than non-VA hospitals on three readmission measures and two effectiveness measures. The performance of VA facilities was significantly better than commercial HMOs and Medicaid HMOs for all 16 outpatient effectiveness measures and for Medicare HMOs, it was significantly better for 14 measures and did not differ for two measures. High variation across VA facilities in the performance of some quality measures was observed, although variation was even greater among non-VA facilities. The VA system performed similarly or better than the non-VA system on most of the nationally recognized measures of inpatient and outpatient care quality, but high variation across VA facilities indicates a need for targeted quality improvement. |
X Demographics
The data shown below were collected from the profiles of 99 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 56 | 57% |
| North Macedonia | 1 | 1% |
| Unknown | 42 | 42% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 44 | 44% |
| Scientists | 33 | 33% |
| Practitioners (doctors, other healthcare professionals) | 15 | 15% |
| Science communicators (journalists, bloggers, editors) | 7 | 7% |
Mendeley readers
The data shown below were compiled from readership statistics for 52 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 52 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 8 | 15% |
| Student > Master | 5 | 10% |
| Student > Doctoral Student | 3 | 6% |
| Student > Postgraduate | 3 | 6% |
| Other | 3 | 6% |
| Other | 7 | 13% |
| Unknown | 23 | 44% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 10 | 19% |
| Social Sciences | 3 | 6% |
| Psychology | 3 | 6% |
| Business, Management and Accounting | 2 | 4% |
| Nursing and Health Professions | 2 | 4% |
| Other | 7 | 13% |
| Unknown | 25 | 48% |
Attention Score in Context
This research output has an Altmetric Attention Score of 197. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 April 2023.
All research outputs
#203,597
of 25,634,695 outputs
Outputs from Journal of General Internal Medicine
#175
of 8,231 outputs
Outputs of similar age
#4,618
of 340,465 outputs
Outputs of similar age from Journal of General Internal Medicine
#3
of 148 outputs
Altmetric has tracked 25,634,695 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 8,231 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 22.2. This one has done particularly well, scoring higher than 97% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 340,465 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 98% of its contemporaries.
We're also able to compare this research output to 148 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 97% of its contemporaries.