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American Journal of Medical Quality, Vol. 22, No. 3, 186-197 (2007)
DOI: 10.1177/1062860607300656
© 2007 American College of Medical Quality

Mortality of Department of Veterans Affairs Patients Admitted to Private Sector Hospitals for 5 Common Medical Conditions

Mary S. Vaughan-Sarrazin, PhD

Health Services Research and Development Service, Veterans Health Administration, Department of Veterans Affairsmary.vaughan{at}med.va.gov, mary-vaughan-sarrazin{at}uiowa.edu, Center for Research in the Implementation of Innovative Strategies in Practice (CRSP), Iowa City VA Medical Center, Iowa City, Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa

Bonnie Wakefield, PhD

Harry S. Truman VA Medical Center, Columbia, Missouri

Gary E. Rosenthal, MD

Center for Research in the Implementation of Innovative Strategies in Practice (CRSP), Iowa City VA Medical Center, Iowa City, Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa

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. (Am J Med Qual 2007;22:186-197)

Key Words: hospital mortality • severity of illness • hospitals • veterans • risk adjustment


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