Veterans who were admitted to a non-Veterans Administration hospital under fee-based care for treatment of hip fracture had lower 1-year mortality rates and shorter time to surgery, according to this study.
“These findings suggest fee-based care, especially for veterans living greater distances from [Veterans Administration] VA hospitals, may improve access to care and health outcomes,” Kelly K. Richardson, PhD, and colleagues wrote in the study abstract.
Richardson and colleagues compared patients admitted to VA hospitals with patients admitted to non-VA hospitals under fee-based (NVA-FB) care between 2003 and 2008. Outcome measurements included time to surgery and death. They used logistic regression to pinpoint characteristics common to NVA-FB hospitals and Cox proportional hazards regression to compare differences in time to surgery and death with controls for patient covariates.
Veterans who went to NVA-FB hospitals tended to be younger, had service-connected disabilities and lived more than 50 miles from a VA hospital, according to the abstract. Richardson and colleagues found patients waited three days until surgery in VA hospitals, compared to one day for NVA-FB hospitals. There was also a 21% lower risk of 1-year mortality in NVA-FB hospitals compared to VA hospitals.
Disclosure: The study was funded by the Department of Veterans Affairs, Veterans Health Administration, Office of Rural Health, Veterans Rural Health Resource Center-Central Region, and the Health Services Research and Development Service, Department of Veterans Affairs and Comprehensive Access & Delivery Research and Evaluation (CADRE) Center at the Iowa City VAMC (REA 09-220).