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Harlan Krumholz

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JAMA study gives good marks to VA hospitals


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Despite occasional controversies, veterans’ hospitals compare  favorably with others in treating older men with three common conditions — heart attacks, heart failure and pneumonia, says a study on death rates and readmissions.

The study, in the Journal of the American Medical Association, said that chances of dying or being readmitted within 30 days of treatment for those conditions varied only slightly  between patients hospitalized within the VA system and outside hospitals.

The Associated Press reported that the results contrast with news stories  about quality questions and long waits for care. They suggest that VA hospitals “are still able to deliver high-quality care for some of the sickest most complicated patients,” Ashish Jha, M.D., a Harvard health-policy expert, said in an editorial published with the JAMA study.

At VA hospitals, death rates were marginally lower after a heart attack — 13.5 percent vs 13.7 percent for outside hospitals; and for heart failure — 11.4 percent vs 11.9 percent. They were slightly higher for pneumonia — 12.6 percent vs. 12.2 percent at non-VA hospitals.

Readmission rates ranged from about 17 percent to 25 percent for the three conditions and were highest at VA hospitals, but only by about 1 percentage point or less.

“Both groups are now working on quality in ways they didn’t a decade ago and the levels of good performance are quite comparable” for the conditions studied, said lead author Harlan Krumholz,  M.D., a Yale University cardiologist and researcher.

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