For many years, physicians have considered the VA an inferior care system. Unbeknownst to most physicians whose only VA experience occurred during their training, the VA has made significant strides over the past 10 years. Attending on the VA wards for 5-6 months each year, I have noticed these strides. A major contributing factor is the BEST electronic medical record that I have seen.

A new study shows that the VA does a better job caring for diabetes than does managed care – Study: VA Bests Managed Care on Diabetes

Diabetic patients treated by the country’s long-maligned VA health system got better care than diabetics under managed health care plans, according to a new study.

Researchers found that the diabetics served by the Department of Veterans Affairs had better control over their cholesterol and got more frequent blood tests, eye and foot exams than diabetics served by the commercial health groups.

The findings appear in Tuesday’s issue of Annals of Internal Medicine. The study was funded by the VA, the U.S. Centers for Disease Control and Prevention, and the National Institute of Diabetes and Digestive Kidney Diseases.

“The VA has made great strides in the past 10 years,” said Dr. Eve A. Kerr, the study’s lead author, who is a research scientist at the VA Ann Arbor Healthcare System and assistant professor of internal medicine at the University of Michigan Medical School. “What this tells us is that a nationally funded health care system can provide excellent quality of care.”

Researchers compared the care received by 6,900 diabetics in eight managed care health plans with about 1,300 diabetics in five VA medical centers in Indiana, California, Texas, Michigan, Pennsylvania and New Jersey. They matched the two patient groups geographically and used statistical sampling to make the demographics comparable.

Compared to their managed care counterparts, diabetes patients treated by VA doctors more often received the recommended annual blood tests (93 percent vs. 83 percent), eye exams (91 percent vs. 75 percent); and foot exams (98 percent vs. 84 percent).

The VA group also received more cholesterol testing (79 percent vs. 63 percent) and had better control of their cholesterol levels as a result, according to the study.

Both groups of patients reported similarly high levels of satisfaction for the care they received.

Why? I would submit that 2 major factors make this result happen. First, VA doctors have more time to see each patient. As physicians have more time, they more likely will address more issues. Second, the VA electronic medical record facilitates tracking.

This study suggests an important subsequent study. We need to better understand the factors that have enabled the VA to surpass managed care. That study might inform a reconsideration of primary care.

Related posts:

1. Improved performance – P4P or consistent primary care?
2. Treating depression to help diabetes
3. Prevention does save money
4. Managed care and medical education
5. Quality care deficiencies

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