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Journal of General Internal Medicine
Erschienen in: Journal of General Internal Medicine 1/2017

15.07.2016 | Review Paper

Comparing VA and Non-VA Quality of Care: A Systematic Review

verfasst von: Claire O’Hanlon, MPP, Christina Huang, PhD, MPH, Elizabeth Sloss, PhD, Rebecca Anhang Price, PhD, Peter Hussey, PhD, Carrie Farmer, PhD, Courtney Gidengil, MD, MPH

Erschienen in: Journal of General Internal Medicine | Ausgabe 1/2017

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Abstract

Background

The Veterans Affairs (VA) health care system aims to provide high-quality medical care to veterans in the USA, but the quality of VA care has recently drawn the concern of Congress. The objective of this study was to systematically review published evidence examining the quality of care provided at VA health care facilities compared to quality of care in other facilities and systems.

Methods

Building on the search strategy and results of a prior systematic review, we searched MEDLINE (from January 1, 2005, to January 1, 2015) to identify relevant articles on the quality of care at VA facilities compared to non-VA facilities. Articles from the prior systematic review published from 2005 and onward were also included and re-abstracted. Studies were classified, analyzed, and summarized by the Institute of Medicine’s quality dimensions.

Results

Sixty-nine articles were identified (including 31 articles from the prior systematic review and 38 new articles) that address one or more Institute of Medicine quality dimensions: safety (34 articles), effectiveness (24 articles), efficiency (9 articles), patient-centeredness (5 articles), equity (4 articles), and timeliness (1 article). Studies of safety and effectiveness indicated generally better or equal performance, with some exceptions. Too few articles related to timeliness, equity, efficiency, and patient-centeredness were found from which to reliably draw conclusions about VA care related to these dimensions.

Discussion

The VA often (but not always) performs better than or similarly to other systems of care with regard to the safety and effectiveness of care. Additional studies of quality of care in the VA are needed on all aspects of quality, but particularly with regard to timeliness, equity, efficiency, and patient-centeredness.
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Metadaten
Titel
Comparing VA and Non-VA Quality of Care: A Systematic Review
verfasst von
Claire O’Hanlon, MPP
Christina Huang, PhD, MPH
Elizabeth Sloss, PhD
Rebecca Anhang Price, PhD
Peter Hussey, PhD
Carrie Farmer, PhD
Courtney Gidengil, MD, MPH
Publikationsdatum
15.07.2016
Verlag
Springer US
Erschienen in
Journal of General Internal Medicine / Ausgabe 1/2017
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-016-3775-2

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