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VA hospitals yield better safety data, worse patient experience compared to non-VA facilities, research suggests

Compared with non-Veterans Affairs hospitals, Veterans Affairs hospitals had better outcomes for most patient safety indicators, but worse outcomes on certain patient experience and behavioral health measures, according to a research letter published in JAMA Internal Medicine.

“Recently, [CMS] announced the inclusion of Veterans Affairs (VA) hospital performance data on its Hospital Compare website,” Eddie Blay Jr, MD, from the Feinberg School of Medicine at Northwestern University, and colleagues wrote. “Prior to this release, comparisons of quality at VA vs. non-VA hospitals were inconclusive and had methodological limitations.”

Blay and colleagues used data from 129 VA and 4,010 non-VA hospitals reported between July 2012 and March 2015 and data from the 2014 American Hospital Association Annual Survey to compare VA and non-VA hospitals regarding available outcome, patient experience and behavioral health measures. They also assessed pairwise comparisons between VA and non-VA hospitals for risk-adjusted rates of 17 outcome measures, including nine Agency for Healthcare Research and Quality Patient Safety Indicators (PSIs), four mortality measures and four readmissions measures, as well as 10 patient experience measures and nine behavioral health measures.

Data showed that for six of nine PSIs, VA hospitals had better outcomes than non-VA hospitals. For the remaining three PSIs, there were no significant differences observed between hospital settings. Furthermore, all mortality and readmission outcomes were better among VA hospitals. However, non-VA hospitals scored better on patient experience measures, including nursing and physician communication, responsiveness, quietness, pain management and whether the patient would recommend the hospital to others. In addition, non-VA hospitals performed better on four of nine behavioral health measures, whereas VA hospitals performed better on one of the nine.

“While concerns remain about the validity of some of the measures used in current public reporting of health quality, the available data suggests that VA hospitals have a similar or more favorable quality compared with non-VA hospitals,” Blay and colleagues concluded. “On the other hand, these results suggest that VA hospitals should focus on improving certain aspects of patient experience and behavioral health. Hospitals can use these data to identify opportunities for quality improvement.” – by Alaina Tedesco

Disclosure: The researchers report funding from NIH.