Featured Research

from universities, journals, and other organizations

U.S. Veterans Health Administration similar or better than private sector for cancer patients ages 65 plus, study finds

Date:
June 6, 2011
Source:
Harvard Medical School
Summary:
Cancer care provided by the U.S. Veterans Health Administration for men 65 years and older is at least as good as, and by some measures better than, Medicare-funded fee-for-service care obtained through the private sector, according to a new study.

A new study finds that the cancer care provided by the Veterans Health Administration (VHA) for men 65 years and older is at least as good as, and by some measures better than, Medicare-funded fee-for-service care obtained through the private sector. The study, reported in the June 7 issue of Annals of Internal Medicine, was led by Nancy Keating, an associate professor of health care policy at Harvard Medical School.

Related Articles


Several factors could account for the high quality of VHA care. "Care in the VHA is much better coordinated than most other settings," said Keating, who is also an associate physician at Brigham and Women's Hospital. "The VHA has a good, integrated medical record. Their doctors all work together and communicate more effectively. There are no incentives for the overuse of cancer treatments because VHA physicians are not rewarded financially for prescribing more drugs or procedures. The VHA also measures quality across a wide range of conditions, so there is a culture of quality improvement."

The VHA is the largest integrated healthcare system in the United States, and veterans who are part of the VHA get almost all of their care from this system. In contrast to the fee-for-service model of care common in the private health sector, the VHA operates on a set budget to provide coordinated and comprehensive healthcare services, and its doctors are salaried. Congress has mandated periodic assessments of the VHA's performance in various domains of health care. In contracting out the VHA's cancer care evaluation, the Office of Policy and Planning of the U.S. Department of Veteran Affairs turned to Keating and her colleagues.

Keating's team pooled registry and administrative data from 2001-2004 for men 65 years and older diagnosed with the three most common cancers in men -- colorectal, lung and prostate cancers -- or hematologic cancers, such as lymphoma and multiple myeloma. The researchers used sophisticated analyses to ensure unbiased comparisons between the VHA and fee-for-service Medicare patients, and compared how well various guideline-recommended criteria for care were met in these two settings.

When compared with fee-for-service Medicare patients, Keating and colleagues found that veterans in the VHA were diagnosed with colorectal cancers at earlier-stages and had higher adjusted rates of certain recommended treatments, including surgery for colon cancer, chemotherapy for lymphoma, and bisphosphonates for myeloma. With regard to other treatments studied, care was fairly equal in quality between the VHA and fee-for-service Medicare.

Keating conducted additional analyses to further account for differences that may exist between veterans and the Medicare population that they could not measure. For example, veterans are often in worse health than the general population. When they updated their results to account for these likely differences in health status, care in the VHA was better than that in fee-for-service Medicare for most indicators. One exception was a likely delay in the adoption of certain new and expensive radiation therapy technologies for prostate cancer.

Overall, rates of recommended care were relatively low in both settings for some of the treatments studied. This may result from lack of data on the benefits versus risks of these drugs in older patients. Keating recommended that cancer clinical trials include older individuals as well as those with comorbid illnesses.

"While the ongoing national health care debate centers on expanding insurance coverage, ensuring a coordinated health care delivery system that provides high-quality care at good value is equally important to improve outcomes and keep rising health care costs in check," said Keating.

This research was funded by the Department of Veterans Affairs Office of Policy and Planning.


Story Source:

The above story is based on materials provided by Harvard Medical School. Note: Materials may be edited for content and length.


Journal References:

  1. Nancy L. Keating, Mary Beth Landrum, Elizabeth B. Lamont, Samuel R. Bozeman, Steven H. Krasnow, Lawrence N. Shulman, Jennifer R. Brown, Craig C. Earle, William K. Oh, Michael Rabin, Barbara J. McNeil. Quality of Care for Older Patients With Cancer in the Veterans Health Administration Versus the Private Sector: A Cohort Study. Annals of Internal Medicine, 2011; 154: 727-736 [link]
  2. Joan J. Ryoo, Jennifer L. Malin. Reconsidering the Veterans Health Administration: A Model and a Moment for Publicly Funded Health Care Delivery. Annals of Internal Medicine, 2011; 154: 772-773 [link]

Cite This Page:

Harvard Medical School. "U.S. Veterans Health Administration similar or better than private sector for cancer patients ages 65 plus, study finds." ScienceDaily. ScienceDaily, 6 June 2011. <www.sciencedaily.com/releases/2011/06/110606171403.htm>.
Harvard Medical School. (2011, June 6). U.S. Veterans Health Administration similar or better than private sector for cancer patients ages 65 plus, study finds. ScienceDaily. Retrieved October 30, 2014 from www.sciencedaily.com/releases/2011/06/110606171403.htm
Harvard Medical School. "U.S. Veterans Health Administration similar or better than private sector for cancer patients ages 65 plus, study finds." ScienceDaily. www.sciencedaily.com/releases/2011/06/110606171403.htm (accessed October 30, 2014).

Share This



More Health & Medicine News

Thursday, October 30, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Mind-Controlled Prosthetic Arm Restores Amputee Dexterity

Mind-Controlled Prosthetic Arm Restores Amputee Dexterity

Reuters - Innovations Video Online (Oct. 29, 2014) A Swedish amputee who became the first person to ever receive a brain controlled prosthetic arm is able to manipulate and handle delicate objects with an unprecedented level of dexterity. The device is connected directly to his bone, nerves and muscles, giving him the ability to control it with his thoughts. Matthew Stock reports. Video provided by Reuters
Powered by NewsLook.com
Google To Use Nanoparticles, Wearables To Detect Disease

Google To Use Nanoparticles, Wearables To Detect Disease

Newsy (Oct. 29, 2014) Google X wants to improve modern medicine with nanoparticles and a wearable device. It's all an attempt to tackle disease detection and prevention. Video provided by Newsy
Powered by NewsLook.com
Can Drinking Milk Lead To Early Death?

Can Drinking Milk Lead To Early Death?

Newsy (Oct. 29, 2014) Researchers in Sweden released a study showing heavy milk drinkers face an increased mortality risk from a variety of causes. Video provided by Newsy
Powered by NewsLook.com
Obama: The US Will Not 'run and Hide' From Ebola

Obama: The US Will Not 'run and Hide' From Ebola

AP (Oct. 29, 2014) Surrounded by health care workers in the White House East Room, President Barack Obama said the U.S. will likely see additional Ebola cases in the weeks ahead. But he said the nation can't seal itself off in the fight against the disease. (Oct. 29) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

    Environment News

    Technology News



    Save/Print:
    Share:

    Free Subscriptions


    Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

    Get Social & Mobile


    Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

    Have Feedback?


    Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
    Mobile: iPhone Android Web
    Follow: Facebook Twitter Google+
    Subscribe: RSS Feeds Email Newsletters
    Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins