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VA Treatment Tops
Managed Care for Diabetes
posted September 07, 2004
Diabetic patients treated by the
country's long-maligned VA health system got better care than diabetics under
managed health care plans.
From the study it was found that, VA patients received the recommended care more
often.
"A nationally funded health care system can provide excellent quality of care,"
Dr. Eve A. Kerr, of the VA Ann Arbor Healthcare System and assistant professor
of internal medicine at the University of Michigan Medical School, said in a
statement.
"The VA has instituted system-wide standards, integrated care, and a way to
track and monitor how their patients are doing. Other organizations can learn
from the VA and how they achieved their quality improvements over the last 10
years," she added.
Her team studied 1285 patients with diabetes treated at five VA medical centers
and 6920 patients treated at 8 commercial managed care health plans.
The researchers looked at whether patients underwent seven standard recommended
tests or services annually. These included eye examination, hemoglobin A1c
measurement, lipid screening, foot examination, proteinuria screening, advice on
aspirin use and influenza vaccination.
They found that 93% of VA patients had an annual hemoglobin A1c test, compared
with 83% of managed care patients. Seventy-five percent of VA patients were told
how aspirin can prevent heart attack and stroke, compared with 49% of managed
care patients.
Ninety-one percent of VA patients had an annual eye exam compared with 75% of
managed care patients.
Because she practices in the VA, Dr. Kerr stated that she was not personally
surprised by the findings. "I have seen the improvements the VA has made in
quality of care first hand. However, for those who aren't aware of these
improvements, and some of my coauthors were not, this finding could be seen as
surprising."
"However, we still need to learn more about which of the many changes the VA
instituted improve quality the most, so that managed care health plans can
implement these in the most cost effective manner," added Dr. Carol Mangione of
the University of California Los Angeles, who also worked on the study.
Source: Diabetes In Control.com: Ann
Intern Med 2004;141:272-281.
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