• Medicine · Jul 2024

    Observational Study

    Acute hospitalizations and outcomes in Veterans Affairs Hospitals 2011 to 2017.

    • Jean Yoon, Ciaran S Phibbs, Michael K Ong, Megan E Vanneman, Kenneth W Kizer, Adam Chow, Andrew Redd, Hao Jiang, and Yue Zhang.
    • Health Economics Resource Center, VA Palo Alto Health Care System, Menlo Park, CA.
    • Medicine (Baltimore). 2024 Jul 26; 103 (30): e38934e38934.

    AbstractHospitals within the Veterans Affairs (VA) health care system exhibited growing use of observation care. It is unknown how this affected VA hospital performance since observation care is not included in acute inpatient measures. To examine changes in VA hospitalization outcomes and whether it was affected by shifting acute inpatient care to observation care. Longitudinal analysis of 986,355 acute hospitalizations and observation stays in 11 states 2011 to 2017. We estimated temporal changes in 30-day mortality, 30-day readmissions, costs, and length of stay (LOS) for all hospitalizations and 6 conditions in adjusted models. Changes in mortality and readmissions were compared including and excluding observation care. A 9% drop in acute hospitalizations was offset by a 157% increase in observation stays 2011 to 2017. A 30-day mortality decreased but readmissions did not when observation stays were included (all P < .05). Mean costs increased modestly; mean LOS was unchanged. There were differences by condition. VA hospital mortality decreased; there was no change in readmissions.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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