Department of Veterans Affairs Reforms To Limit Hospital Stays Did Not Affect Patient Care, Study Finds
Reforms implemented by the Department of Veterans Affairs in 1995 to eliminate or decrease the length of hospital stays in the VA health system reduced hospital use by 50% over five years and did not affect the quality of care for veterans, according to a study published Thursday in the New England Journal of Medicine, the AP/New York Times reports. In the study, Carol Ashton, director of the VA Houston Center for Quality of Care and Utilization Studies, and colleagues examined the one-year survival rates of 342,300 of veterans with one of nine serious chronic illnesses -- six physical and three mental -- who received care from VA hospitals between 1994 and 1998 (AP/New York Times, 10/23). The study found that total VA hospital use decreased by 50% over the five-year period; use for veterans with heart failure decreased by 43%, and use for veterans with mood disorders decreased 60%, according to the study. In addition, the study found that over the five-year period, urgent care visits at VA hospitals decreased by 37%, and visits at VA outpatient facilities, such as clinics, increased 10% (Fackelmann, USA Today, 10/23). According to the study, one-year survival rates for veterans with one of five of the nine illnesses examined increased between 0.2% and 1.4%, and survival rates for veterans with one of the four other illnesses examined remained the same (AP/New York Times, 10/23).
The VA health system saved about 25% on hospital costs between 1995 and 1999, in large part because of a reduction in unnecessary hospital stays, Kenneth Kizer, the former head of the VA health system who developed the 1995 reforms, said. Ashton said that veterans today receive "lots of routine care" to help prevent illnesses that may have required hospital care, USA Today reports (USA Today, 10/23). She added that the results of the study indicate "that you don't necessarily need to go to a hospital to get good, solid medical care" (AP/New York Times, 10/23). In an editorial that accompanied the study, Dr. Elliot Fisher, co-director of the VA Outcomes Group, said that the results indicate that more hospital care does not equate to more effective care. "Hospitals can be dangerous places if you don't need to be there" because patients could develop infections or experience medical errors, Fisher said (USA Today, 10/23). An abstract of the study is available online.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.