The Veterans Affairs (VA) health system fares slightly better than other hospitals when it comes to lower mortality rates among older men with heart attack, heart failure, or pneumonia, according to a new study by Yale School of Medicine researchers.

The study, published in the current issue of Journal of the American Medical Association, also showed slightly higher readmission rates at VA hospitals for all three conditions, both nationally and within similar geographic areas.

"There has recently been a lot of discussion around the VA health system, but there was limited knowledge about comparative hospital performance between VA and non-VA hospitals regarding important outcomes of care," said first author Sudhakar V. Nuti, a first-year student at Yale School of Medicine. "Given how important veterans are to our country, we wanted to investigate how well we are caring for them when they are sick and vulnerable. Overall, the differences in mortality and readmission rates were small, which indicates that the VA health care system is doing comparatively well for patients hospitalized with these common medical conditions."

Nuti and his colleagues used National Quality Forum-endorsed measures to compare mortality and readmission rates between male Medicare fee-for-service beneficiaries age 65 years or older hospitalized in VA and non-VA hospitals for three common medical conditions. Since geographic differences could account for differences in performance, they also studied hospitals in similar geographic areas.

"Although there is room for improvement given the variation in performance found across both hospital systems, the results of this study should be reassuring to veterans and the general public regarding the quality of care in VA hospitals for key medical conditions," said senior author Harlan Krumholz, the Harold H. Hines Jr. Professor of Medicine, professor of investigative medicine and of public health, and co-director of the Clinical Scholars Program.

"It will remain critical to continue to monitor these outcome metrics and target low-performing hospitals for improvement," Krumholz added.

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Other authors of the study included Drs. Li Qin, John S. Rumsfeld, Joseph S. Ross, Frederick A. Masoudi, Sharon-Lise T. Normand, Karthik Murugiah, Susannah M. Bernheim, and Lisa G. Suter.

The study was supported by a grant from the National Heart, Lung, and Blood Institute.