Charles A. Bertrand, M.D., FACP, DIM-CD (Ret.)
Associate Clinical Professor of Medicine at New York Medical College
and at the Medical University of South Carolina


DOES VA HEALTH-CARE MEASURE UP?

If a patient is admitted to the hospital and treated properly and then discharged from hospital in good health and without complications -- it is not news. It doesn't make the newspapers, or any of the other facets of the media.

But let there be a bad result, a rare or exotic situation, a new treatment or medicine developed (even lacking much documentation) then it may be highlighted on the news and is published. This "sells newspapers ".

For years the VA health care system has received bad press about its quality of health care- but does it deserve a "bad rap"?

"Does VA Health Care Measure Up?" is the title of an editorial in the New England Journal of Medicine December 28, 2000. It relates to a study published in the same issue about the treatment of heart attacks comparing the effectiveness of treatment of veterans in VA hospitals as compared to medicare patients in non-VA hospitals.

The title is "Outcome of Myocardial Infarction (heart attack) in Veterans Health Administration Patients as Compared with Medicare patients." In essence, 2486 veterans who had heart attacks were compared with 29, 249 medicare patients. All were male, all were 65 years of age or older. The treatment given and the outcomes encountered were compared for the 2 groups of patients.

Even though the veterans had more co- existing disorders (such as diabetes or high blood pressure) than the medicare patients there was no difference in mortality at 30 days or for one year. The quality of care was basically the same in both groups.

I find it reassuring that good medical care is provided by our VA hospitals and especially so with our baby boomers coming of age; doubtless many will avail themselves of these facilities in the years to come.



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