Mortality of Department of Veterans Affairs patients admitted to private sector hospitals for 5 common medical conditions.
Whether prior use of Veterans Affairs services is a marker for increased mortality was evaluated by using Medicare data for men aged 67 years and older admitted for acute myocardial infarction, chronic heart failure, chronic obstructive pulmonary disease, pneumonia, or stroke during 1996 to 2002. Patients using Veterans Affairs services during the 2 years preceding hospital admission were identified using Veterans Affairs encounter data, and 30-day mortality was compared in patients who did and did not use Veterans Affairs services, adjusting for patient risk factors. For most Veterans Affairs users, the odds of death were similar or slightly less than the odds of death for nonusers. For acute myocardial infarction, pneumonia, and stroke, the risk of death was slightly higher for Veterans Affairs users with low income. Results using propensity-matched samples were similar. The use of Veterans Affairs services is not a strong marker of unmeasured severity among patients in private sector hospitals.
Vaughan-Sarrazin
Mary S
MS
Center for Research in the Implementation of Innovative Strategies in Practice (CRIISP), Iowa City VA Medical Center, Iowa City, IA 52246, USA. mary.vaughan@med.va.gov
Wakefield
Bonnie
B
Rosenthal
Gary E
GE
D000368:Aged; D015331:Cohort Studies; D006333:Heart Failure / Q000401:mortality; D017052:Hospital Mortality; D016304:Hospitals, Private / Q000706:statistics & numerical data*; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data; D009203:Myocardial Infarction / Q000401:mortality; D011014:Pneumonia / Q000401:mortality; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality; D012189:Retrospective Studies; D020521:Stroke / Q000401:mortality; D014481:United States; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data*