Comparing Complication Rates After Elective Total Knee Arthroplasty Delivered Or Purchased By The VA.
Health Aff (Millwood)
; 40(8): 1312-1320, 2021 08.
Article
en En
| MEDLINE
| ID: mdl-34339235
ABSTRACT
The Department of Veterans Affairs (VA) both delivers health care in its own facilities and, increasingly, purchases care for veterans in the community. Policy makers, administrators, health care providers, and veterans frequently face decisions about which services should be delivered versus purchased by the VA. Comparisons of quality across settings are essential if veterans are to receive care that is consistently accessible, patient centered, effective, and safe. We compared risk-adjusted major postoperative complication rates for total knee arthroplasties that were delivered in VA facilities versus purchased from community providers. Overall, adjusted complication rates were significantly lower for arthroplasties delivered by the VA compared with those that were purchased. However, hospital-level comparisons revealed five locations where VA-purchased care outperformed VA-delivered care. As the amount of VA-purchased care continues to increase under the Veterans Access, Choice, and Accountability Act of 2014 and the VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018, these results support VA monitoring of overall and local comparative hospital performance to improve the quality of the care that the VA delivers while ensuring optimal outcomes in VA-purchased care.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Veteranos
/
Artroplastia de Reemplazo de Rodilla
Límite:
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Health Aff (Millwood)
Año:
2021
Tipo del documento:
Article