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VA researchers looked at data on more than 27,000 Veterans age 65 and older who received chemotherapy for cancer between 2010 and 2014. (Photo for illustrative purposes only. ©iStock/FatCamera)
June 17, 2020
Tristan Horrom
VA Research Communications
"Our work indicates that VA does a better job of preventing adverse events for Veterans receiving chemotherapy than do non-VA providers."
Patients receiving chemotherapy through VA were less likely to experience potentially avoidable hospitalizations than those getting Medicare-paid chemotherapy, found a study by VA Palo Alto researchers. The results led the researchers to conclude that “Veterans with cancer receive higher-quality care in VA” than in the private sector.
The findings appeared online May 13, 2020, in the journal Cancer.
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Lead study author Dr. Risha Gidwani-Marszowski, a VA Palo Alto and Stanford University researcher, explains the significance of the results. “Our work indicates that VA does a better job of preventing adverse events for Veterans receiving chemotherapy than do non-VA providers,” she says. “Therefore, as the VA contracts out more care to the private sector, it is crucial that VA monitor the quality of care Veterans receive in these environments and intervene if any decrements in care quality are detected.”
With passage of the Veterans Choice Act in 2014 and MISSION Act in 2018, more Veterans are seeking care outside the VA health system. According to the researchers, “it is critical to understand whether this shift in system of care will impact care quality.”
To study this, they looked at data on more than 27,000 Veterans age 65 and older who received chemotherapy for cancer between 2010 and 2014. All patients were enrolled in both VA and Medicare. About 35% received the treatment through VA, while 65% used Medicare.
Chemotherapy can prolong the life of cancer patients. But the toxic side effects of the treatment can lead to serious health consequences, which often require hospitalization.
About 6% of the total group were hospitalized in the first 30 days after chemo with a potentially avoidable condition. The most common reasons for hospitalizations were pneumonia, sepsis, anemia, and pain.
The study found that Medicare patients were significantly more likely than VA patients to be hospitalized with one of these conditions. About 7% of Medicare patients had a potentially avoidable hospitalization. Only 4.6% of VA patients were hospitalized with an avoidable condition.
The rate of hospitalization was not affected by demographics such as race, rurality, or distance a patient lived from a VA facility.
The study highlights the high quality of care Veterans receive through VA, according to the researchers. “As more Veterans receive care in the private sector that is paid by VA,” says Gidwani-Marszowski, “it’s important to ensure they don’t receive poorer quality care than they would have if they had been treated by VA.”
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