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VA Provides Safer, More Effective Care Than Other Systems: Rand

Department of Veterans Affairs

Department of Veterans Affairs facilities often provide safer and more effective care than other health care systems, a new report finds, though researchers stopped short of comparing such factors as wait times.

"In terms of safety, VA facilities performed similarly or better in most, but not all, studies comparing morbidity and mortality. Results from studies about complications and patient safety indicators were more mixed," the report says. "In terms of effectiveness, VA facilities had similar or superior quality to non-VA facilities with respect to preventive, recommended, and end-of-life care, as well as managing medications."

Rather than collect new data, the report released today by the Rand Corporation looked at 69 studies conducted between 2005 and 2015 about the quality, effectiveness and availability of care at VA facilities versus civilian doctors through private health insurance, civilian hospitals or Medicaid and Medicare.

Researchers then aggregated the results of those studies in an attempt to draw conclusions about overall department treatment benchmarks.

Due to a lack of information in the reviewed studies, researchers were unable to draw conclusions about the VA's wait times, which the report calls "timeliness," or equity, efficiency of care or patient-centeredness, the summary says.

"The Rand study found there was too little information ... to reliably draw conclusions about how the VA system compared to others across these dimensions," it says.

While the results showed that the VA provides similar if not better care than non-department providers, "no stark trends can be observed about whether [service availability] performance in the VA is better or worse than in other health settings," a report summary says.

Although services may be generally available through the VA, the system has been under constant fire from advocacy groups and Congress over long wait times for veterans who want to access them.

A report released in April by the Government Accountability Office found that veterans wait three to eight weeks for medical appointments. A 2014 scandal revealed the VA improperly manipulated reported appointment wait times.

Researchers noted that the studies the paper examined compare the VA to the performance of other health care systems -- not to any specific ideal.

"I think it's important to note that we are comparing the VA to other health care settings that are not perfect either," said Dr. Courtney Gidengil, a researcher who helped write the report.

Gidengil said she hopes the findings are encouraging for patients and their families.

"I hope that it can potentially give some reassurance about quality, at least compared to other health care systems," she said.

Department officials said they are happy with the results.

"We are pleased that after reviewing 69 studies Rand found that VA's health care compares favorably ... with health care delivered outside VA," said Victoria Dillon, a VA spokesperson. "We have always felt health care delivered at VA was excellent and are pleased a third party was able to validate this."

The report was ordered by Congress in 2014 as part of the Veterans Choice Act.

-- Amy Bushatz can be reached at amy.bushatz@military.com.

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