Association of Admission to Veterans Affairs Hospitals vs Non–Veterans Affairs Hospitals With Mortality and Readmission Rates Among Older Men Hospitalized With Acute Myocardial Infarction, Heart Failure, or Pneumonia

Abstract

The Department of Veterans Affairs (VA) and the Centers for Medicare & Medicaid Services (CMS) are collaborating in calculating and reporting hospital performance. The alignment of reporting systems provides an opportunity to compare performance of VA and non-VA hospitals directly with respect to risk-adjusted outcomes for key conditions, including acute myocardial infarction (AMI), heart failure (HF), or pneumonia. Prior studies, which are a decade or more old or are not nationally representative, and occurred before validated hospital-level outcome measures existed, found that patients who received care at VA hospitals had either similar or lower mortality rates than patients who received care at non-VA hospitals^1-4; with respect to readmission rates, a study in New York found that elderly patients had higher rates of 30-day readmission in VA hospitals than in non-VA hospitals.⁵ Contemporary knowledge about hospital-level outcomes would help to better understand quality of care for the approximately 9 million veterans enrolled in the nation’s largest integrated health care system compared with those in Medicare.⁶