An Ambulance-transported Veteran has a Survival Advantage at VA Hospitals

An Ambulance-transported Veteran has a Survival Advantage at VA Hospitals

Veterans Health Administration (VHA), operated by the Department of Veterans Affairs (VA), is the country's biggest medical care system, with 171 hospitals and more than 1,000 clinics.

Disputes have existed concerning the quality and accessibility of services since its establishment in 1930.

A recent study found that veterans transported by ambulance to VA hospitals had better 30-day survival rates than those transported to non-VA hospitals. Black and Hispanic patients had a better survival rate than those who'd been to the hospital before.

Carnegie Mellon University (CMU), Stanford University, the University of California, Berkeley, and the Department of Veterans Affairs conducted the investigation. It is scheduled for publication by The British Medical Journal.

In most prior studies on the quality of VA healthcare, veterans receiving care in the VA system are compared with those receiving care elsewhere, a comparison that may yield inaccurate results if these patient populations are fundamentally different. 

According to Lowell Taylor, professor of economics at CMU's Heinz College, who co-authored the study, "Veterans are a distinct group, so researchers are unlikely to control for big underlying differences between veterans and non-veterans."

Researchers in this study tracked 30-day mortality in veterans aged 65 years or older who met two criteria: They were enrolled in both Medicare and the VHA. Their care began with an ambulance ride initiated by 911 for emergency treatment. 

Because these vets were eligible for care in both VA and non-VA hospitals, along with the emergency nature of their visit, there was very little chance of them self-selecting. 

Besides assessing the veterans' residences, primary care, demographics, and the ambulances' life support capabilities, which can skew comparisons, the study also analyzed other factors.

The study looked at emergency ambulance visits by more than 580,000 veterans in 46 states and the District of Columbia. There were also 30-day mortality rates measured.

Patients referred to VA hospitals had a mortality rate at 30 days that was 20% lower than patients referred to non-VA hospitals. Black and Hispanic patients, however, had the most significant mortality advantage regardless of the patient's gender, age, or preexisting condition.

While the study's design reduces the risk of confounding, it doesn't eliminate it. The study included older veterans, so the results may not apply to younger veterans or episodes of care that are not the result of emergency treatment. 

Additionally, the authors maintain that further research is needed to uncover the nature of the mortality advantage.