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Comment & Response
May 2018

Importance of Objectively Comparing Local VA and Non-VA Care and OutcomesServing Veterans Well

Author Affiliations
  • 1Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire
JAMA Cardiol. 2018;3(5):443. doi:10.1001/jamacardio.2018.0338

Comparing younger veterans’ elective percutaneous coronary interventions and coronary artery bypass grafts performed in Veterans Affairs medical centers (VAMCs) with those purchased through the VA’s Community Care Program and provided in community hospitals, Barnett et al1 found that community hospitals were closer to patients, had higher percutaneous coronary intervention (but lower coronary artery bypass graft) costs, and had higher percutaneous coronary intervention risk-adjusted mortality rates than VAMCs. The authors concluded that the VA serves veterans well and recommended that the Community Care Program use selective contracting based on community hospitals’ quality and transparency to improve veterans’ outcomes.

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