Study: VA Efforts to Improve End of Life Care are Working
New research shows that efforts by the Department of Veterans Affairs to increase access to hospice care to veterans of the Armed Forces have been successful. The results of the study, which show greater growth in hospice use by beneficiaries enrolled in VA health care compared to those in Medicare, was published in the journal Health Affairs.
The data for the study was collected by the Geriatrics and Extended Care Data Analysis Center (GECDAC) centered at the Canandaigua VA Medical Center, an organization that provides planning, policy, and management guidance to the VA Office of Geriatrics and Extended Care. The GECDAC is headed by Orna Intrator, Ph.D., who is also a professor in the University of Rochester Medical Center (URMC) Department of Public Health Sciences.
Intrator is a co-author of the study, which was also presented at a briefing on Advance Illness and End-Of-Life Care at the National Press Club in Washington earlier this month.
The VA launched its Comprehensive End-of-Life Care initiative in 2009. The efforts focused on expanding access for veterans to palliative and hospice care services at VA hospitals and nursing homes and through civilian health providers. Studies have shown that access to these services results in care that is more aligned with the wishes of patients and families.
The current study looked at hospice use from more than a million veterans age 65 and older between 2007 and 2014. The researchers compared this group with a demographically similar sample of Medicare beneficiaries. They found that while hospice use among Medicare patients grew by 5.6 percent over the period, veterans enrolled in VA health care witnessed a 7.6 to 7.9 percent increase.
The next step for the GECDAC, according to Intrator, is to look at hospice care rates across the VA’s 141 medical centers and examine which medical centers demonstrated higher rates compared to Medicare beneficiaries in their communities. Findings from this study can help identify effective strategies that can be applied across the VA health system.
Additional co-authors of the study include lead author Susan C. Miller with Brown University, Winifred Scott with the Palo Alto VA Medical Center, Scott Shreve with the Lebanon VA Medical Center, Ciaran Phibbs with GECDAC and Stanford University, Bruce Kinosian with the GECDAC and the University of Pennsylvania, and Richard Allman and Thomas Edes with the Department of Veterans Affairs. The study was funded with support from the Office of Geriatrics and Extended Care of the Veterans Health Administration.
Mark Michaud |