Mortality and length of stay in a Veterans affairs hospital and private sector hospitals serving a common market

Gary E ROSENTHAL; Mary VAUGHAN SARRAZIN; Dwain L HARPER; Susan M FUEHRER

doi:10.1046/j.1525-1497.2003.11209.x

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Mortality and length of stay in a Veterans affairs hospital and private sector hospitals serving a common market

Journal article

Peer reviewed

Mortality and length of stay in a Veterans affairs hospital and private sector hospitals serving a common market

Gary E ROSENTHAL, Mary VAUGHAN SARRAZIN, Dwain L HARPER and Susan M FUEHRER

Journal of general internal medicine : JGIM, Vol.18(8), pp.601-608

2003

DOI: 10.1046/j.1525-1497.2003.11209.x

PMID: 12911641

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https://www.ncbi.nlm.nih.gov/pmc/articles/1494896View

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Abstract

Objective: To compare severity-adjusted in-hospital mortality and length of stay (LOS) in a Veterans Administration (VA) hospital and private sector hospitals serving the same health care market. Design: Retrospective cohort study. Setting: A large VA hospital and 27 private sector hospitals in the same metropolitan area. Patients: Consecutive VA (N = 1,960) and private sector (N = 157,147) admissions in 1994 to 1995 with 9 high-volume diagnoses. Measurements: Severity of illness was measured using validated multivariable models that were based on data abstracted from medical records. Outcomes were adjusted for severity and compared in VA and private sector patients using multiple logistic or linear regression analysis. Main results: Unadjusted mortality was similar in VA and private sector patients (5.0% vs 5.6%, respectively; P =.26), although mean LOS was longer in VA patients (12.7 vs 7.0 days; P <.001). Adjusting for severity, the odds of death in VA patients was similar (odds ratio [OR] 1.07; 95% confidence interval [95% CI], 0.74 to 1.54; P =.73). However, a larger proportion of deaths in VA patients occurred later during hospitalization (P <.001), and the odds of death in VA patients were actually lower (P <.05) in analyses limited to deaths during the first 7 (OR, 0.56) or 14 (OR, 0.63) days. Adjusted LOS was longer (P <.001) in VA patients for all 9 diagnoses. Conclusions: If the current findings generalizable to other markets, hospital mortality, a widely used performance measure, may be similar or lower in VA and private sector hospitals serving the same markets. The longer LOS of VA patients may reflect differences in practice patterns and may be an important source of bias in comparisons of VA and private sector hospitals.

Public health. Hygiene-occupational medicine

Public health. Hygiene

Biological and medical sciences

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Medical sciences

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Details

Title: Subtitle: Mortality and length of stay in a Veterans affairs hospital and private sector hospitals serving a common market
Creators: Gary E ROSENTHAL - Division of General Internal Medicine, Iowa City VA Medical Center and the University of Iowa College of Medicine, Iowa City, Iowa, United States
Mary VAUGHAN SARRAZIN - Division of General Internal Medicine, Iowa City VA Medical Center and the University of Iowa College of Medicine, Iowa City, Iowa, United States
Dwain L HARPER - Quality Information Management Corporation, Cleveland, Ohio, United States
Susan M FUEHRER - Cleveland VA Medical Center, Cleveland, Ohio, United States
Resource Type: Journal article
Publication Details: Journal of general internal medicine : JGIM, Vol.18(8), pp.601-608
DOI: 10.1046/j.1525-1497.2003.11209.x
PMID: 12911641
NLM abbreviation: J Gen Intern Med
ISSN: 0884-8734
eISSN: 1525-1497
Publisher: Springer; Heidelberg
Language: English
Date published: 2003
Academic Unit: Health Management and Policy; General Internal Medicine; Internal Medicine
Record Identifier: 9984064190402771

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