WSJ Analysis: VA Hospitals Vary Widely in Patient Care

Tuesday, 03 Jun 2014 10:27 AM

By Melanie Batley

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There are significant discrepancies in treatment results across VA hospitals, an analysis by The Wall Street Journal has found, with significantly higher rates of mortality and dangerous infections at the Phoenix facility, where news of 40 deaths sparked the crisis at the Department of Veterans Affairs.

A detailed tabulation of internal records showed that the rate of potentially lethal bloodstream infections at the Phoenix facility was more than 11 times higher than at top VA hospitals. Patients that are otherwise healthy could die within days or even hours of contracting those types of infections.

Although the data obtained by the Journal did not show the percentage of patients that died as a result of the infections, among patients in critical care at the Phoenix facility, there was a 32 percent higher 30-day death rate than the best performing VA hospitals.

By contrast, Boston's VA hospital had a bloodstream-infection rate that was 63 percent below the average of top-performing facilities, and better results for the 30-day rate of death in acute care, the analysis showed.

"Wide variations are a problem at both the VA and private hospitals. But I would expect to see much smaller variations in a national, integrated delivery system like the VA," Ashish Jha, a professor at the Harvard School of Public Health and a physician in the VA system, told the Journal.

The nonpublic data has in the past been touted by the VA inspector general as a useful barometer for pointing out significant problems at individual hospitals, but a spokesman for the Phoenix facility, Scott McRoberts, told the Journal that the database "is an internal measurement system to benchmark our improvement, and is not for public consumption."

Another VA spokesman told the Journal that it was useful for the agency but "still very much a work in progress," and refused to address variations in care.

The data is used to rank hospitals on a five-star rating system, with one star being the lowest in quality. Houston's VA Hospital, for example, has a two-star ranking, and the data showed that it had a 47 percent higher acute-care mortality rate than a five-star counterpart.

For the last few years, the VA has taken steps to publish a variety of healthcare quality data for its hospitals, but the practice has sparked internal conflict over how much information should be released to the public.

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