Government and Regulations

Meta-Analysis Examines Quality of VA Health Care

VA facilities delivered “the same, if not better,” quality of care when compared to private facilities.


In Congressional testimony, VA officials frequently tout studies that indicate that the VA delivers high-quality health care that meets or exceeds the care delivered at private facilities. These studies often stand in sharp contrast to the criticism leveled at the VA and news stories of health care discrepancies. However, a new meta-analysis of studies on quality at VA facilities suggests that the VA health care system generally performs better than or similar to other health care systems for providing safe and effective care to patients.

The study, published in the Journal of General Internal Medicine and conducted by RAND Corporation researcher Courtney Gidengil , MD, MPH, found 69 articles on VA quality across dimensions, including safety and effectiveness. According to Dr. Gidengil, 22 of 34 safety studies and 20 of 24 studies that focused on effectiveness showed that VA facilities provided the same, if not better, quality of care as do private facilities. These studies focused on safety measures, preventive medicine best practices. In the studies, surgical patients in the VA system and VA nursing homes patients had death rates similar to patients in other health systems.

“We found that the overall quality of care in the VA health system compares favorably to other segments of the U.S. health care system,” said Dr. Gidengil. “In some areas, the quality of care provided by the VA exceeded what we found in other settings, although there were areas where the quality of VA care fell short.”

The study updated and expanded on a similar study conducted in 2009. In addressing timeliness, equity, efficiency, and patient-centeredness, there was too little data to draw reliable conclusions. Similarly, studies on the availability of services had mixed results. During the past 5 years, the study was not able to find any trends indicating whether the VA was superior or inferior compared with other health settings.

“Comparing the VA to other health care settings can be difficult because the VA has a patient population that is different from most other settings, with patients who may be sicker,” Gidengil said. “But it's important to do more of this work in the future so we can better understand the quality of care the VA provides.”

Support for the study was provided by the VA.

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