Skip Navigation U.S. Department of Health and Human Services www.hhs.gov
Agency for Healthcare Research Quality www.ahrq.gov
Archive print banner

Quality/Patient Safety

This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://info.ahrq.gov. Let us know the nature of the problem, the Web address of what you want, and your contact information.

Please go to www.ahrq.gov for current information.

Veterans Health Administration clinics provide better overall quality of care than many other sites

Patients seen at Veterans Health Administration (VHA) clinics receive better overall quality of care, chronic disease care, and preventive care than those seen at other community sites. The VHA has championed a more coordinated system of care since the early 1990s, when they initiated a sophisticated electronic medical record system, measurement of performance on several quality measures, and a system-wide commitment to quality improvement, explains Elizabeth A. McGlynn, Ph.D., of RAND Health.

In a study that was supported in part by the Agency for Healthcare Research and Quality (HS09463), Dr. McGlynn and her colleagues compared the quality of care at 26 clinical sites in 12 VHA health systems with care received by a random sample of adult males older than 35 years of age in 12 communities between 1997 and 2000. The researchers used a chart-based quality instrument consisting of 348 quality of care indicators targeting 26 conditions ranging from asthma and urinary tract infection to diabetes, depression, and preventive care. After adjusting for clustering, patient age, number of visits, and medical conditions, VHA patients scored significantly higher than those at other sites for overall quality (67 vs. 51 percent), chronic disease care (72 vs. 59 percent), and preventive care (64 vs. 44 percent) but not for acute care.

The VHA advantage was most prominent in processes targeted by VHA performance measurement (66 vs. 43 percent) and least prominent in areas unrelated to VHA performance measurement (55 vs. 50 percent). To date, the VHA has not targeted acute care as part of its performance measurement system. These findings suggest that VHA performance measurement efforts are indeed contributing to better quality of care at VA clinics.

More details are in "Comparison of quality of care for patients in the Veterans Health Administration and patients in a national sample," by Steven M. Asch, M.D., M.P.H., Dr. McGlynn, Mary M. Hogan, Ph.D., and others, in the December 21, 2004, Annals of Internal Medicine 141(12), p. 938-945.

Return to Contents
Proceed to Next Article

The information on this page is archived and provided for reference purposes only.

 

AHRQ Advancing Excellence in Health Care