Download or read book Comparison of Quality of Care in VA and Non VA Settings A Systematic Review written by United States. Department of Veterans Affairs and published by . This book was released on 2010 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Comparison of Quality of Care in VA and Non VA Settings a Systematic Review written by U. S. Department of Veterans Affairs and published by Createspace Independent Pub. This book was released on 2013-05-29 with total page 62 pages. Available in PDF, EPUB and Kindle. Book excerpt: It remains unclear where the Veterans Health Administration (VA) finds itself in the spectrum of care currently available in the United States. The quality of care provided by the VA has been subject to debate since, and well before, the VA's system transformation starting in the mid-90s. Media and entertainment vehicles have, rightly or wrongly, not infrequently portrayed VA care in less than optimal light, although there have been notable exceptions1. Regardless of media views, the VA has established itself as an innovative healthcare system, including implementation of its advanced electronic medical record, with broad clinical and educational missions. The immediate objective of this project is to conduct a systematic literature review of the published literature comparing the quality of medical and surgical care provided by the VA to relevant non-VA healthcare facilities and systems. The Key Question was: Compare and contrast studies that assess VA and non-VA quality of care for surgical, nonsurgical and other medical conditions.
Download or read book Comparison of Quality of Care in VA and Non VA Settings written by Paul G. Shekelle and published by . This book was released on 2010 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book VA Versus Non VA Quality of Care written by Paul G. Shekelle and published by . This book was released on 2023 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Department of Veterans Affairs (VA) Veterans Health Administration (VHA) is the nation's largest integrated healthcare system. Comparing the quality of VA-delivered healthcare to care delivered in non-VA settings is one way of ensuring VA maintains its commitment to providing high-quality care to Veterans. To support this aim, the VA's Evidence Synthesis Program (ESP) systematically reviews studies comparing the quality of VA and non-VA healthcare. This systematic review is frequently updated with the most recently available evidence; the current report was previously updated in February 2023.
Download or read book Comparison of Quality of Care in VA and Non VA Settings written by United States. Department of Veterans Affairs. Health Services Research and Development Service and published by . This book was released on 2010 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Rural Vs Urban Ambulatory Health Care written by U. S. Department of Veterans Affairs and published by Createspace Independent Pub. This book was released on 2013-05-23 with total page 104 pages. Available in PDF, EPUB and Kindle. Book excerpt: Approximately 3 million veterans, slightly more than one-third of all veterans enrolled in the Department of Veterans Affairs (VA) health care system, live in rural areas. This pattern is likely to continue, as a comparable proportion of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans are from rural areas. The Rural Veterans Care Act of 2006 was signed into law to improve care for rural veterans. Ensuring that the health care needs of rural veterans are met has become a top priority for VA, resulting in a considerable expansion of community based outpatient clinics (CBOCs), inclusion of rural health/access as a research priority, and creation of the VA Office of Rural Health (ORH) in 2006. Although there have been reports comparing health quality of life (both physical and mental) for rural and urban veterans, it remains unclear whether the observed lower health quality of life in rural veterans is due to disparities in health care, differences in disease prevalence, or other population differences. This systematic review examines the evidence regarding potential disparities between rural and urban areas in health care provision and delivery, and how differences in health care may contribute to disparities in health outcomes. Differences in rural-urban prevalence rates of diseases and other health conditions are beyond the scope of this review. Because veterans who use VA health care have been found to use more non-VA health care overall, we expanded the focus of this review to include comparisons of rural vs. urban health care in non-VA health systems. Our first goal was to determine if a health care disparity exists across the urban-rural spectrum. For a disparity to exist, it would have to be demonstrated that health care outcomes of patients in rural areas differ from those of patients treated in urban areas for similar conditions. Because differences in health care process or delivery do not necessarily lead to disparities, we looked for evidence associating differences with poorer health outcomes. For the purposes of this review we conceptualized rural-urban disparities as differences in health care quality or availability. A second goal of the review was to identify areas for intervention should any disparities be found. In order to develop a meaningful intervention, specific information regarding differences in the structure of health care and the way it is administered (i.e., the process) would be critical. Since differences in health outcomes can occur for reasons other than differences in the health care systems themselves (e.g., accessibility), our third goal was to examine what, if any, nonhealth care factors (e.g., travel distance to a clinic) affected health outcomes. Because veterans who use VA health care actually use more non-VA health care overall,9 we expanded the focus of this review to include comparisons of rural vs. urban health care in non-VA health systems The key questions were: Key Question #1. Do adults with health care needs who live in rural areas have different intermediate (e.g., hemoglobin A1c [HbA1c], Blood pressure, etc.) or final health outcomes (i.e., mortality, morbidity, quality of life [QOL]) than those living in urban areas? Key Question #2. Is the structure (e.g., types of available providers) or the process (e.g., likelihood of referral) of health care different for adults with health care needs who live in urban vs. rural environments? Key Question #3. If there are differences in the structure or the process of health care in rural vs. urban environments, do those differences contribute to variation in overall or intermediate health outcomes for adults with health care needs? Key Question #4. If there are differences in intermediate or final health outcomes for adult patients with health care needs, what other systems factors moderate those differences (e.g., availability of specialists, type of treatment needed, travel distance)?
Download or read book Rural Vs Urban Ambulatory Health Care written by and published by . This book was released on 2011 with total page 100 pages. Available in PDF, EPUB and Kindle. Book excerpt: Approximately 3 million veterans, slightly more than one-third of all veterans enrolled in the Department of Veterans Affairs (VA) health care system, live in rural areas. This pattern is likely to continue, as a comparable proportion of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans are from rural areas. The Rural Veterans Care Act of 2006 was signed into law to improve care for rural veterans. Ensuring that the health care needs of rural veterans are met has become a top priority for VA, resulting in a considerable expansion of community based outpatient clinics (CBOCs), inclusion of rural health/access as a research priority, and creation of the VA Office of Rural Health (ORH) in 2006. Although there have been reports comparing health quality of life (both physical and mental) for rural and urban veterans, it remains unclear whether the observed lower health quality of life in rural veterans is due to disparities in health care, differences in disease prevalence, or other population differences. This systematic review examines the evidence regarding potential disparities between rural and urban areas in health care provision and delivery, and how differences in health care may contribute to disparities in health outcomes. Differences in rural-urban prevalence rates of diseases and other health conditions are beyond the scope of this review. Because veterans who use VA health care have been found to use more non-VA health care overall, we expanded the focus of this review to include comparisons of rural vs. urban health care in non-VA health systems.
Download or read book Racial and Ethnic Disparities in the Va Healthcare System written by Department of Veterans Affairs and published by CreateSpace. This book was released on 2013-08 with total page 74 pages. Available in PDF, EPUB and Kindle. Book excerpt: Numerous studies have demonstrated racial and ethnic differences in health care in the United States. These studies have collectively demonstrated that both the quantity and quality of health care are lower for minority Americans—African Americans and Hispanics in particular—as compared to the white majority. Studies have found racial differences in the use of lifesaving surgeries and other invasive procedures, in technical processes of health care delivery, and in interpersonal interactions between patients and providers. The root causes of racial differences in health care remain unclear, but in general, they are not explained by differences in clinical factors or patient preferences; i.e., the differences represent inequity in health care delivery. The Institute of Medicine has referred to these inequitable differences as disparities. Differences in ability to pay for care—as measured by health insurance and income—also do not explain the majority of observed racial disparities. Importantly, disparities in health care have been demonstrated in the Veterans Affairs (VA) healthcare system, where financial barriers to receiving care are minimized. The VA is committed to delivering high-quality care in an equitable manner, and as such, to eliminating racial and ethnic disparities in health care. To inform this effort, the VA has invested in research on disparities by making Equity one of the priority areas within its Health Services Research and Development (HSR&D) Service. Through its Equity portfolio, the VA HSR&D Service seeks to further knowledge of the root causes of racial and ethnic disparities in health care and to develop and test interventions to reduce and eliminate disparities. Over time, evidence about disparities in VA care has accumulated through research supported by HSR&D and other VA and non-VA sponsors. The HSR&D Service sought to take stock of this evidence, to inform future research within its Equity portfolio, particularly intervention research; i.e., what does the accumulated evidence tell us will be the most promising areas for interventions to reduce and eventually eliminate racial and ethnic disparities within the VA? Although studies from outside the VA healthcare system may hold important lessons for reducing racial disparities both within and outside the VA, in consultation with our technical expert advisory group we chose to limit our review to studies conducted within the VA. The rationale for this restriction on the scope of the review was threefold: 1) as an integrated, staff model health care organization, the VA is different from the broader U.S. healthcare environment, making the causes of racial and ethnic disparities potentially different as well; 2) as an “equal access” system, the VA reduces the influence of potential confounders of racial disparities, such as insurance and income, and therefore providers a “cleaner laboratory” for studying disparities; and 3) the body of literature on racial disparities in healthcare is sufficiently large that a comprehensive review of both VA and non-VA studies would not have been feasible with the resources available. We conducted this review with the following objectives: 1. Determine in which clinical areas racial and ethnic disparities are prevalent within the VA; 2. Describe what is known about the sources of those disparities; and 3. Qualitatively synthesize that knowledge to determine the most promising avenues for future research aimed at improving equity in VA health care.
Download or read book Public Presentation of Health System Or Facility Data about Quality and Safety a Systematic Review written by U. S. Department of Veterans Affairs and published by Createspace Independent Pub. This book was released on 2013-05-28 with total page 62 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Department of Veterans Affairs (VA) “Open Government Plan” outlines the agency's commitment to transparency, and defines transparency as both increasing access to public information and enabling better engagement and advocacy on behalf of Veterans. Key elements of the transparency initiative involve public presentation of health system and facility data about quality of care and safety. Examples include the VA Hospital Compare website, which provides outcomes and process data for selected diagnoses and the ASPIRE dashboard, which reports quality and safety goals for all VA hospitals. There are many reasons to make quality and safety information available to the public. One of the key goals of public reporting is to improve the quality of services. Theories and experience suggest multiple pathways from public reporting to health services improvement and ultimately to better patient outcomes. In a situation where patients and families have a choice among health care providers (systems or facilities), quality information makes it possible for patients to select providers based on performance. Public reporting also “levels the playing field” by making the knowledge about quality more accessible to patients. Without public reporting this information may only be known by providers. In turn, concern about loss of market share may motivate providers to improve processes and strive to improve outcomes. Publicly available data may also give provider organizations direct incentives to improve care. Report cards, rankings, and websites about quality allow organizations to compare their performance to that of their peers, but also make providers aware that others can make these comparisons as well. Concern about reputation can itself be a powerful motivator for change. Patient advocates, policy makers, and the media can also use publicly reported data to identify high and low performing organizations, track change over time, and promote high quality care. VA is committed to making its publicly reported performance data as accessible and useful as possible. This review and synthesis seeks to identify the key lessons for VA drawn from available research on public reporting that could be applied to future VA transparency efforts. The Key Questions were: 1. What is the most effective way of displaying quality and service information so that it is understandable? 2. How do patients prefer to receive or access this information? 3. What is the evidence that patients or their families use publicly reported quality and safety information to make informed health care decisions? 4. What is the evidence that public reporting of quality and safety information leads to improved quality of safety?
Download or read book Evaluation of the Department of Veterans Affairs Mental Health Services written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-03-29 with total page 467 pages. Available in PDF, EPUB and Kindle. Book excerpt: Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental healthâ€"related outcomesâ€"in particular, suicideâ€"at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services.
Download or read book Advances in Patient Safety written by Kerm Henriksen and published by . This book was released on 2005 with total page 526 pages. Available in PDF, EPUB and Kindle. Book excerpt: v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products.
Download or read book Comparison of Joint Replacement Disparities in VA and Non VA Settings written by and published by . This book was released on with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Finding What Works in Health Care written by Institute of Medicine and published by National Academies Press. This book was released on 2011-07-20 with total page 267 pages. Available in PDF, EPUB and Kindle. Book excerpt: Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.
Download or read book Returning Home from Iraq and Afghanistan written by Institute of Medicine and published by National Academies Press. This book was released on 2010-03-31 with total page 193 pages. Available in PDF, EPUB and Kindle. Book excerpt: Nearly 1.9 million U.S. troops have been deployed to Afghanistan and Iraq since October 2001. Many service members and veterans face serious challenges in readjusting to normal life after returning home. This initial book presents findings on the most critical challenges, and lays out the blueprint for the second phase of the study to determine how best to meet the needs of returning troops and their families.
Download or read book Improving Quality of Care written by RAND Health and published by . This book was released on 2005 with total page 2 pages. Available in PDF, EPUB and Kindle. Book excerpt: Summarizes the article by Steven M. Asch and others, Comparison of quality of care for patients in the Veterans Health Administration and patients in a national sample, in Annals of internal medicine (v. 141, no. 12, Dec. 21, 2004).
Download or read book Wounds of War written by Suzanne Gordon and published by Cornell University Press. This book was released on 2018-10-15 with total page 582 pages. Available in PDF, EPUB and Kindle. Book excerpt: U.S. military conflicts abroad have left nine million Americans dependent on the Veterans Health Administration (VHA) for medical care. Their "wounds of war" are treated by the largest hospital system in the country—one that has come under fire from critics in the White House, on Capitol Hill, and in the nation's media. In Wounds of War, Suzanne Gordon draws on five years of observational research to describe how the VHA does a better job than private sector institutions offering primary and geriatric care, mental health and home care services, and support for patients nearing the end of life. In the unusual culture of solidarity between patients and providers that the VHA has fostered, Gordon finds a working model for higher-quality health care and a much-needed alternative to the practice of for-profit medicine.
Download or read book Cochrane Handbook for Systematic Reviews of Interventions written by Julian P. T. Higgins and published by Wiley. This book was released on 2008-11-24 with total page 672 pages. Available in PDF, EPUB and Kindle. Book excerpt: Healthcare providers, consumers, researchers and policy makers are inundated with unmanageable amounts of information, including evidence from healthcare research. It has become impossible for all to have the time and resources to find, appraise and interpret this evidence and incorporate it into healthcare decisions. Cochrane Reviews respond to this challenge by identifying, appraising and synthesizing research-based evidence and presenting it in a standardized format, published in The Cochrane Library (www.thecochranelibrary.com). The Cochrane Handbook for Systematic Reviews of Interventions contains methodological guidance for the preparation and maintenance of Cochrane intervention reviews. Written in a clear and accessible format, it is the essential manual for all those preparing, maintaining and reading Cochrane reviews. Many of the principles and methods described here are appropriate for systematic reviews applied to other types of research and to systematic reviews of interventions undertaken by others. It is hoped therefore that this book will be invaluable to all those who want to understand the role of systematic reviews, critically appraise published reviews or perform reviews themselves.
