Michael E. DeBakey VA Medical Center - Houston, Texas
American Journal of Public Health Cites VA's Health Care Successes
January 3, 2008
The December issue of The American Journal of Public Health includes an editorial and articles commending the Department of Veterans Affairs’ health care system, saying VA has emerged as a national health care leader.
An editorial headlined, “The Veterans Health Administration: A Domestic Model for a National Health Care System,” states that the VA system has several unique aspects that distinguish it from the private sector health care system:
- a centralized health care administration;
- an emphasis on preventive (primary) care as the foundation for the system;
- an automated health information system that includes a national electronic patient record system; and
- an affordable, evidence-based medication prescription plan.
“These are qualities that are clearly lacking in most American market-based private health care systems,” the editorial states. It points out that the transformations have taken place even though the VA patient population has a disproportionately lower income and is older, sicker and more likely to suffer from mental and behavioral issues than the private sector.
The editorial is authored by Dr. Said Ibrahim of the Center for Health Equity Research and Promotion at VA’s Pittsburgh Health Care System and the Division of General Internal Medicine at the University of Pittsburgh.
Dr. Ibrahim also cites recent studies on the performance of the VA health care system that show marked improvements in the performance of the VA health care system compared with the market-based, private health care system. He says the private health care system “is increasingly seen as too costly and too inadequate in its performance.”
The editorial points out, however, that VA faces some critical challenges, such as the need for reforms in the management of post-traumatic stress disorder (PTSD), and it points out there a large number of veterans with health care access problems unable to receive care at VA medical centers.
A separate article in the same December issue, praises VA leadership, saying changes made in the 1990s such as instituting a nationwide electronic health record and accompanying quality measurement approach led to the transformation of VA to become a national leader.
The article, “Designing a Model Health Care System,” also cites several academic studies which show that VA care outperforms non VA care on various areas, and that patient satisfaction appears to be higher within the VA than among those who receive care in the private sector.
The author, Dr. Kevin Volpp, is with the Center for Health Equity Research and Promotion, VA Hospital in Philadelphia and the Department of Medicine at the University of Pennsylvania in Philadelphia.
Dr. Volpp concludes that VA could enhance its impact by reaching out more actively to recently discharge military personnel to ensure they receive the care they need, though he notes there has been recent improvement in this area.
He also states it is important for VA to continue to invest heavily in research for physical and mental health problems resulting from intense combat as well as to enable VA to understand what it does well and what areas need improvement.
“By many metrics, the VA has established itself as a leader in health care delivery within the United States,” Volpp concludes. “However, more can be done to show the way for the rest of the country in using data-driven approaches to design and test innovative efforts to improving health.”