The VA and Non-VA Experience of Tracking Good Care.
The VA and Non-VA Experience of Tracking Good Care.
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VA 和非 VA 跟踪良好护理的经验。
DOI：
10.1089/pop.2019.0039
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发表时间：
2020
影响因子：
2.5
通讯作者：
Hung,William
中科院分区：
文献类型：
--
作者：
Langhoff,Erik;Siu,Albert;Boockvar,Kenneth;Bund,Linda;Connell,Jim;Hung,William
2018年的退伍军人事务部使命法案允许为社区中的900万退伍军人选择医疗保健，但决定最好的医疗保健需要透明度。最近的报告质疑美国最大的医疗保健组织退伍军人事务部（VA）报告医疗保健结果的透明度，指出VA如何跟踪和提高绩效的缺陷，并对使用流行的医院评级系统定义良好护理的有效性和透明度提出质疑。为了进一步探索这一点，作者研究了3个广泛引用的公共卫生保健排名模型-美国新闻美国最佳医院，Truven健康分析和医院比较-以及VA模型。经过检查，作者发现，这4种模型使用的指标既不可比，也不透明。在非VA医院的医院指标报告中发现了6%-46%的报告缺陷，这降低了公众的透明度。相反，VA报告为100%。比较VA医疗保健和医院比较质量结果显示，对于相同的质量指标和可比的医疗保健成本，VA的结果相似或更好。VA住院病人满意度福尔斯明显低于私营部门，但没有发现个别VA结果指标对住院病人满意度有显着贡献。然而，随着全球医院在VA和非VA医疗保健方面的排名的提高，整体住院患者满意度随着时间的推移而提高。鼓励使用统一的评级模型和报告所有医院的指标将提高当前医疗保健报告给消费者的透明度。
The VA Mission Act of 2018 allows for choice of health care for 9 million veterans in their community, but deciding where the best care is requires transparency. Recent reports questioning the transparency of reporting health care outcomes in the Department of Veterans Affairs (VA), the largest US health care organization, pointed to flaws in how VA tracks and improves performance, and posed questions about the validity and transparency of using popular hospital ratings systems to define good care. To explore this further, the authors examined 3 widely referenced public health care ranking models – U.S. News America's Best Hospitals, Truven Health Analytics, and Hospital Compare – and the VA model. Upon examination, the authors find that metrics used across the 4 models are neither comparable nor transparent. Between 6%–46% reporting deficiencies were found in reporting of hospital metrics in non-VA hospitals, which reduces transparency for the public. In contrast, VA reporting is 100%. Comparing VA health care and Hospital Compare quality outcomes showed similar or better outcomes for VA for the same metrics of quality and for comparable health care costs. VA inpatient satisfaction falls significantly short of the private sector, but no individual VA outcome measure was found to contribute significantly to inpatient satisfaction. However, overall inpatient satisfaction increased over time with higher global hospital ranking in both VA and non-VA health care. Encouraging use of uniform rating models and reporting of metrics from all hospitals would improve transparency of current health care reporting to the consumer.