Comparing VA and Non-VA Medical Centers: Informing Veteran Health Care Choice at the MISSION Act Watershed

Abstract

This study compared clinical quality and patient experience in US Department of Veterans Affairs (VA) and non-VA hospitals. One hospital was identified for each full-service VA hospital (<em>n</em> = 125 pairs). Hospitals were compared on four Agency for Healthcare Research and Quality (AHRQ) clinical indicators: Influenza immunization (IMM-2), Patient Safety Indicator 04 (PSI 04), Catheter-associated Urinary Tract Infection (CAUTI), Methicillin-resistant Staphylococcus aureus infection (MRSA); and three patient experience indicators: the three-item care transition measure (CTM-3) and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) #18 and #19. In aggregate, VA hospitals fared significantly better than non-VA hospitals for PSI 04 and CTM-3. Non-VA hospitals fared significantly better for IMM-2 and HCAHPS #18. No differences were found for CAUTI, MRSA, and HCAHPS #19. At the pairwise level, VA hospitals performed the same as or better than the grand mean for each measure except for IMM-2. This study reinforces previous findings in that the data do not mirror public perception of a universally troubled VA system. This study will be helpful as it is one of the last studies published with the latest pre-MISSION Act data.