Effect of the Transformation of the Veterans Affairs Health Care System on the Quality of Care
Datos Bibliográficos
| ID | 23371607 |
|---|---|
| Autores | Ashish K Jha (0000-0002-6602-6444, Brigham and Women's Hospital), Jonathan B Perlin (0000-0002-2036-9652, United States Department of Veterans Affairs), KENNETH W KIZER (0000-0003-3762-2340, National Quality Forum), R Adams Dudley (0000-0002-8532-8552, University of California, San Francisco) |
| Año | 2003 |
| Volumen | 348 |
| Número | 22 |
| Páginas | 2218-2227 |
| Fecha de publicación | 2003-05-29 |
| Peer Reviewed | Sí |
| Open Access | No |
| Tipo | ARTICLE |
| Revista | New England Journal of Medicine (JOURNAL) |
| Identificadores de la revista | ISSN: 0028-4793 • E-ISSN: 1533-4406 |
| Editorial | Massachusetts Medical Society (PUBLISHER • US) |
| DOI | 10.1056/nejmsa021899 |
| PMID | 12773650 |
| OpenAlex | W2068657668 |
| Idioma | EN |
| Citas recibidas | 69 |
| Referencias citadas | 20 |
BACKGROUND: In the mid-1990s, the Department of Veterans Affairs (VA) health care system initiated a systemwide reengineering to, among other things, improve its quality of care. We sought to determine the subsequent change in the quality of health care and to compare the quality with that of the Medicare fee-for-service program. METHODS: Using data from an ongoing performance-evaluation program in the VA, we evaluated the quality of preventive, acute, and chronic care. We assessed the change in quality-of-care indicators from 1994 (before reengineering) through 2000 and compared the quality of care with that afforded by the Medicare fee-for-service system, using the same indicators of quality. RESULTS: In fiscal year 2000, throughout the VA system, the percentage of patients receiving appropriate care was 90 percent or greater for 9 of 17 quality-of-care indicators and exceeded 70 percent for 13 of 17 indicators. There were statistically significant improvements in quality from 1994-1995 through 2000 for all nine indicators that were collected in all years. As compared with the Medicare fee-for-service program, the VA performed significantly better on all 11 similar quality indicators for the period from 1997 through 1999. In 2000, the VA outperformed Medicare on 12 of 13 indicators. CONCLUSIONS: The quality of care in the VA health care system substantially improved after the implementation of a systemwide reengineering and, during the period from 1997 through 2000, was significantly better than that in the Medicare fee-for-service program. These data suggest that the quality-improvement initiatives adopted by the VA in the mid-1990s were effective.
Business · Business process reengineering · Family medicine · Health care · Health care quality · Managed care · Medical emergency · Quality (philosophy) · Quality management · Service (business) · Veterans Affairs · Healthcare Policy and Management · Marketing · Medicine · Patient Satisfaction in Healthcare · Primary Care and Health Outcomes
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Health Care Employee Perceptions of Patient-Centered Care
Racial and Insurance Status Disparities in Patient Safety Indicators among Hospitalized Patients
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Impact of a High-deductible Health Plan on Outpatient Visits and Associated Diagnostic Tests
Associations Between Provider Designation and Female-specific Cancer Screening in Women Veterans
Responding to the psychological impact of war on the Iraqi people and U.S. veterans
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Change in health status and mortality as indicators of outcomes
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Learning to Walk Slow
Perceived Racial Discrimination in Health Care
Using Research to Transform Care for Women Veterans
Diabetes care among veteran women with disability
Mental Illness
Gender Differences in Smoking and Smoking Cessation Treatment
Gender Differences in Veterans Health Administration Mental Health Service Use
Rural‐Urban Differences in Inpatient Quality of Care in US Veterans With Ischemic Stroke
Do Older Rural and Urban Veterans Experience Different Rates of Unplanned Readmission to VA and Non‐VA Hospitals
Systematic Review
The quality and outcomes framework reduces disparities in health outcomes for cardiovascular disease
Racial/Ethnic Disparities in Health Care Receipt Among Male Cancer Survivors
Performance Measures, Vaccinations, and Pneumonia Rates Among High-Risk Patients in Veterans Administration Health Care
The Struggle for Health Equity
Designing a Model Health Care System
Reducing Avoidable Deaths Among Veterans
The Evolution of Changes in Primary Care Delivery Underlying the Veterans Health Administration’s Quality Transformation
Information Technology as a Tool to Improve the Quality of American Indian Health Care
Use of Preventive Care by Elderly Male Veterans Receiving Care Through the Veterans Health Administration, Medicare Fee-for-Service, and Medicare HMO Plans
The Veterans Health Administration
Changes in Veterans’ Use of Outpatient Care From 1992 to 2000
Good Diabetes Care
Reliance on Veterans Affairs Outpatient Care by Medicare-eligible Veterans
A Decade With the Chronic Care Model
Measuring Performance Directly Using the Veterans Health Administration Electronic Medical Record
Comparison of Administrative Data and Medical Records to Measure the Quality of Medical Care Provided to Vulnerable Older Patients
Quality Improvement Strategies for Hypertension Management
Risk-Adjusted Mortality as an Indicator of Outcomes
Clinical Management Strategies and Diabetes Quality
Dual Use of Veterans Affairs Services and Use of Recommended Ambulatory Care
Organizational Factors Affecting the Likelihood of Cancer Screening Among VA Patients
Slack Resources and Quality of Primary Care
Use of the Veterans’ Choice Program and Attrition From Veterans Health Administration Primary Care
Increased Documented Brief Alcohol Interventions With a Performance Measure and Electronic Decision Support
Examining the Impact of the AHRQ Patient Safety Indicators (PSIs) on the Veterans Health Administration
Race, Poverty, and Mental Health Drive Colorectal Cancer Screening Disparities in the Veterans Health Administration
Area-Level Variations in Cancer Care and Outcomes
The Veterans Health Administration in the Context of Health Insurance Reform
Veterans Health Administration Patients’ Use of the Private Sector for Coronary Revascularization In New York
Comparing Rates of Adverse Events and Medical Errors on Inpatient Psychiatric Units at Veterans Health Administration and Community-based General Hospitals
The Veterans Affairs Healthcare System
The Use and Misuse of Thrombolytic Therapy Within the Veterans Health Administration
Electronic Health Record Components and the Quality of Care
Improving Health Care Quality
Ascertainment of Testosterone Prescribing Practices in the VA
Improved Cardiovascular Risk Prediction Using Nonparametric Regression and Electronic Health Record Data
Comparing the Characteristics, Utilization, Efficiency, and Outcomes of VA and Non-VA Inpatient Care Provided to VA Enrollees
Trends in the Inpatient Quality Indicators
Overuse and Systems of Care
When VA Patients Have Non-VA Hospitalizations, Who Pays for What Services, and What Are the Research Implications
Case-Finding for Depression Among Medical Outpatients in the Veterans Health Administration
Routine Outcomes Monitoring to Support Improving Care for Schizophrenia
Variation in Long-Term Postoperative Mortality Risk by Race/Ethnicity After Major Non-cardiac Surgeries in the Veterans Health Administration
Innovation without Reputation
Through Their Eyes
Integrating network theory into the study of integrated healthcare
The Urgent Need to Improve Health Care Quality Institute of Medicine National Roundtable on Health Care Quality
Health-Related Quality of Life in Patients Served by the Department of Veterans Affairs
Inequality in Quality
Racial Disparities in the Quality of Care for Enrollees in Medicare Managed Care
Quality Enhancement Research Initiative (Queri)
Benchmarking Veterans Affairs Medical Centers in the Delivery of Preventive Health Services
| Obras citantes distintas | 69 |
|---|---|
| Citas por año | 3,14 |
| Intervalo de citas | 2004 - 2025 (22) |
| Velocidad de citación | recent |
| Altamente citado | No |
| Tipos de cita | Neutras: 61 |