Community-Based Outpatient Clinics (CBOC)
From 1995 to 1998, VHA approved over 230 community-based outpatient clinics (CBOCs) and by the end of fiscal year 1998, over 130 CBOCs were actively providing health care to veterans. Because of this rapid growth and in order to learn about these CBOCs, the Under Secretary for Health requested that the Health Services Research and Development Service (HSR&D), through its Management Decision and Research Center (MDRC), conduct a system-wide evaluation of CBOCs.
In response to the Under Secretary's request, the MDRC contracted with the HSR&D Center of Excellence at Seattle, in collaboration with the HSR&D Centers of Excellence in Little Rock and Minneapolis, to design and carry out the evaluation. The study team convened a national CBOC Performance Evaluation Committee with representation from VHA Headquarters, HSR&D, VISN offices, VA medical facilities, and CBOCs to guide the development of potential CBOC performance measures and characteristics by which CBOCs would be profiled. The committee identified potential performance measures in six areas: access, patient satisfaction, utilization, quality, cost and mental health.
Five study reports are linked to this webpage:
- CBOC Characteristics (246KB, PDF)
Profiles the characteristics of CBOCs that completed the congressional review process and began serving veterans between March 1995 and September 1998. - Performance Report 1: Measures Based on Austin Automation Center and Patient Survey Data (788KB, PDF)
Provides results for 12 CBOC performance measures in five of the six domains - access, mental health, quality of care, patient satisfaction, and utilization. - Performance Report 2: Cost and Access Measures (810KB, PDF)
Presents results for three cost measures and two access measures of CBOC performance. - Performance Report 3: Quality of Care Measures Based on Medical Record Review (567KB, PDF)
Presents the results for two CBOC quality of care measures based on seven indicators from the Prevention Index (PI) and nine indicators from the Chronic Disease Care Index (CDI). - Program Implications and Future Performance Measures (684KB, PDF)
Summarizes program implications and presents a set of recommended measures that could be used for ongoing monitoring of CBOC performance.
Note that these are only measures recommended by the HSR&D Evaluation team. They have not been formally received or adopted by the Office of Quality and Performance.