MedicalResearch.com Interview with:
Claire O’Hanlon, MPP
Pardee RAND Graduate School and
Courtney Gidengil, MD, MPH
MedicalResearch.com: What is the background for this study?
Response: Providing high-quality health care is central to our nation’s commitment to veterans, but the quality of care provided in Veterans Affairs health care system (VA) is a longstanding area of concern. Part of the 2014 Veterans Access, Choice and Accountability Act (VACAA) mandated an independent assessment of VA’s health care capabilities and resources of the Veterans Health Administration, including a comprehensive evaluation of health care quality. As part of this evaluation we conducted this systematic review of journal articles that compare quality of care at the VA to other settings as an update to a 2009 review on this subject.
MedicalResearch.com: What are the main findings?
Response: We organized results along six quality dimensions: safety, effectiveness, timeliness, equity, efficiency, and patient-centeredness. Although the studies we found were too heterogeneous to conduct a meta-analysis, the evidence indicates that studies evaluating the safety and/or effectiveness of care provided at VA health care settings were generally better or comparable to non-VA settings. Almost all of the studies we looked at made some attempt to ensure the comparability of populations by adjusting results to account for differences in people who use VA facilities versus those who do not. We did not find enough articles related to timeliness, equity, efficiency, and patient-centeredness to reliably draw conclusions about VA care related to these dimensions.
MedicalResearch.com: What should readers take away from your report?
Response: We found that the VA health system performed better than or similar to other health care systems in providing safe and effective care, although there were some exceptions. However, there weren’t enough studies about other critical aspects of health care quality at the VA to draw conclusions on timeliness, equity, efficiency, and patient-centeredness.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Of all of the research gaps surrounding VA care, the lack of research on the timeliness of care in VA settings is the most troublesome. Long waits at the VA have been the subject of media scrutiny over the last few years, but more high-quality studies that explicitly compare the VA to other health care settings in terms of timeliness will provide significant value as we attempt to address the issue.
MedicalResearch.com: Is there anything else you would like to add?
Response: Although the results of our study were largely consistent with the previous review done in this area, quality of care should continue to be monitored to ensure that the VA can provide high-quality health care to all veterans.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
O’Hanlon, C., Huang, C., Sloss, E. et al.
J GEN INTERN MED (2016). doi:10.1007/s11606-016-3775-2
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