In the past several years, the VHA has reorganized with the integration of services within 22 geographically based groups of hospitals or regions (VISNs).
Purpose: The purpose of this presentation is to describe the functional status of veterans in terms of the differences observed at the hospital (small area) and VISN (large area) levels.
Methods: The ‘1999 Health Survey of Veterans,’ was administered in 1999 to 1.5 million veterans nationally in the VHA and 60.1% (n=845,387) responded. The Veterans SF-36 (short form health survey for veterans) was the measure of functional status. Physical (PCS) and mental (MCS) summaries are standardized to the U.S. population (mean=50, SD=10). Variance components analysis was performed with adjustments for age, gender, education, employment, marital status and race.
Results: Patients were on average 63.4 years of age, with 95.9% male and 76.8% white. Overall, PCS and MCS scores were 36.0 and 44.8, respectively. For PCS, scores by VISN ranged from 32.7 to 40.0 (70% of a SD difference). For MCS, scores by VISN ranged from 42.0 to 47.1 (50% of a SD difference). Variance components for PCS indicated that 5.8 times more of the variability is due to VISN variation when compared to hospital variability within VISN (3.56% versus 0.4%). For MCS, it was 1.2 times more for the VISNs (0.98% versus 0.73%).
Conclusions: Variation is greater amongst VISNs than among hospitals within VISNs. These results are likely to be partly a consequence of recent VHA reorganization and integration of health care services.
Learning Objectives: 1. To describe the health status of veterans by region on a national basis in the VHA. 2. To assess the variation of veterans’ health empirically by region. 3. To discuss the implications of the differences observed of the health status of veterans in terms of the VHA reorganization
Keywords: Veterans' Health,
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Office of Performance & Quality, Veterans Health Administration
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: employment & grants