Newspaper Analysis Challenges Quality of Veterans’ Health Care
While the Department of Veterans Affairs' health care system has received praise for the transformation it has undergone in recent years, officials routinely have overstated the system's successes, according to an analysis by McClatchy Newspapers, McClatchy/Raleigh News & Observer reports.
"In general, the VA has highlighted what it says are superior conditions in its health system," but on "key issues of access, satisfaction and quality of care ... other data contradict the agency's statements," McClatchy/News & Observer reports.
For example, in 2006, VA said that 95% of appointments took place within 30 days of the patient's desired date. However, a 2005 report by the agency's inspector general found that VA schedulers often recorded the wrong requested appointment dates in the system, making wait times appear to be shorter than they actually were.
The report found that 41% of appointments contained errors in veterans' desired dates and that 65% of a specific type of appointment analyzed was within 30 days of the desired date.
Meanwhile, VA Secretary Jim Nicholson in February told Congress that VA satisfaction ratings were "10 points higher than the rating for inpatient care provided by the private sector health care industry," adding, "VA's rating of 82 for outpatient care was eight points better than the private sector." However, McClatchy's review of the relevant data from the University of Michigan American Customer Satisfaction Index found that VA officials compared the agency's inpatient and outpatient satisfaction scores to private hospitals' total scores, which also included emergency department data.
David VanAmburg, director of the annual survey, said ED care "is a far less satisfying experience compared to inpatient and outpatient services," adding that comparing the VA's data with the private sector's overall rating "is not necessarily an apples-to-apples comparison."
If the VA were to use direct inpatient and outpatient comparisons, the gap would narrow to a four-point difference compared with the private sector. After adjusting for age and gender differences between the VA and the private sector, the gap would tighten to a three-point difference, which still is significant, according to VanAmburg.
McClatchy/News & Observer also reports that Nicholson and other officials "repeatedly have cited a study by" RAND to prove the quality of VA care. Nicholson said the study "ranked the overall quality of VA medical care as significantly higher than any other health care system in this country." However, "[a]s it turns out, the RAND study was neither fully independent nor all that recent," according to McClatchy/News & Observer.
The study was conducted by researchers who received grants from VA and was based on data from 1997 to 1999, a period of time when the VA health system saw far fewer patients.
The McClatchy investigation also revealed a number of other inconsistencies with the VA's portrayal of the study.
Meanwhile, Michael Kussman, VA's acting undersecretary for health, in March said there "are over 200" post-traumatic stress disorder treatment teams across all 155 VA hospitals nationwide.
However, the McClatchy investigation found that 40 hospitals do not have the specialized PTSD treatment teams (Adams, McClatchy/Raleigh News & Observer, 5/11).