Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2003 Aug;18(8):601-8.
doi: 10.1046/j.1525-1497.2003.11209.x.

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

Gary E Rosenthal  1 , Mary Vaughan Sarrazin, Dwain L Harper, Susan M Fuehrer
Affiliations
Comparative Study

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

Gary E Rosenthal et al. J Gen Intern Med. 2003 Aug.

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.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Ellwod PM. Shattuck lecture. Outcomes management: a technology of patient experience. N Engl J Med. 1988:1549–56. - PubMed
    1. Roper WL, Winkenwerder W, Hackbarth GM, Krakauer H. Effectiveness in health care: an initiative to evaluate and improve medical practice. N Engl J Med. 1988;319:1197–202. - PubMed
    1. Doing what counts for patient safety: Federal actions to reduce medical errors and their impact. Washington, DC: Quality Interagency Coordination Task Force; QuIC Report to the President. 1999;February 21. Available at: http://www.quic.gov. Accessed June 24, 2003.
    1. Committee on Quality Health Care in America. Crossing the Quality Chasm: A New Health Care System for the 21st Century. Washington, DC: National Academy Press; 2001.
    1. Khuri SF, Daley J, Henderson W, et al. The National Veterans Administration Surgical Risk Study: risk adjustment for the comparative assessment of the quality of surgical care. J Am Coll Surg. 1995;180:519–31. - PubMed

Publication types