Observation Rates At Veterans' Hospitals More Than Doubled During 2005-13, Similar To Medicare Trends

Brad Wright; Amy M J O'Shea; Padmaja Ayyagari; Patience G Ugwi; Peter Kaboli; Mary Vaughan Sarrazin

doi:10.1377/hlthaff.2014.1474

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Observation Rates At Veterans' Hospitals More Than Doubled During 2005-13, Similar To Medicare Trends

Journal article

Open access

Peer reviewed

Observation Rates At Veterans' Hospitals More Than Doubled During 2005-13, Similar To Medicare Trends

Brad Wright, Amy M J O'Shea, Padmaja Ayyagari, Patience G Ugwi, Peter Kaboli and Mary Vaughan Sarrazin

Health affairs (Project Hope), Vol.34(10), pp.1730-1737

10/2015

DOI: 10.1377/hlthaff.2014.1474

PMID: 26438750

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Abstract

When neither inpatient admission nor prompt discharge is clearly indicated for a patient in the emergency department, physicians place the patient under observation in a hospital for diagnosis and treatment. The increasing prevalence of observation stays at hospitals reimbursed by Medicare is receiving considerable attention, but the prevalence remains unexplored in Veterans Health Administration (VHA) hospitals, which are subject to different payment policies. Using VHA data for fiscal years 2005-13, we identified trends and variations in observation rates across twenty-one Veteran Integrated Service Networks and 128 VHA hospitals nationwide. We found that observation rates across VHA hospitals more than doubled, from 6.5 percent to 13.8 percent, and that there was substantial variation across both Veteran Integrated Service Networks and hospitals. The most prevalent diagnoses accounted for an increasing share of observation stays over time. Despite different incentives within the VHA and Medicare, rates of observation have increased over time for both populations.

United States - epidemiology

Hospitals, Veterans - statistics & numerical data

Humans

Medicare - statistics & numerical data

Hospitalization - statistics & numerical data

United States Department of Veterans Affairs

Hospitals, Veterans - economics

Details

Title: Subtitle: Observation Rates At Veterans' Hospitals More Than Doubled During 2005-13, Similar To Medicare Trends
Creators: Brad Wright - Brad Wright (brad-wright@uiowa.edu) is an assistant professor in the Department of Health Management and Policy and at the Public Policy Center, both at the University of Iowa, in Iowa City
Amy M J O'Shea - Amy M. J. O'Shea is a research health specialist at the Iowa City Veterans Affairs Healthcare System and a research associate in the Department of Internal Medicine, Carver College of Medicine, at the University of Iowa
Padmaja Ayyagari - Padmaja Ayyagari is an assistant professor in the Department of Health Management and Policy at the University of Iowa
Patience G Ugwi - Patience G. Ugwi is a doctoral student in the Department of Health Management and Policy at the University of Iowa
Peter Kaboli - Peter Kaboli is an investigator at the Iowa City Veterans Affairs Healthcare System and a professor in the Department of Internal Medicine, Carver College of Medicine, at the University of Iowa
Mary Vaughan Sarrazin - Mary Vaughan Sarrazin is an investigator at the Iowa City Veterans Affairs Healthcare System and an associate professor in the Department of Internal Medicine, Carver College of Medicine, at the University of Iowa
Resource Type: Journal article
Publication Details: Health affairs (Project Hope), Vol.34(10), pp.1730-1737
DOI: 10.1377/hlthaff.2014.1474
PMID: 26438750
NLM abbreviation: Health Aff (Millwood)
ISSN: 0278-2715
eISSN: 1544-5208
Publisher: United States
Language: English
Date published: 10/2015
Academic Unit: Health Management and Policy; Epidemiology; Public Policy Center (Archive); General Internal Medicine; Internal Medicine
Record Identifier: 9984064193502771

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