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Admission to VA or Non-VA Hospitals Impacts Outcome

Lower 30-day mortality for AMI, heart failure, but not pneumonia, with admission to VA hospitals

TUESDAY, Feb. 9, 2016 (HealthDay News) — For older men, mortality and readmission for acute myocardial infarction (AMI), heart failure, and pneumonia vary with admission to Veterans Affairs (VA) and non-VA hospitals, according to a study published in the Feb. 9 issue of the Journal of the American Medical Association.

Sudhakar V. Nuti, from the Yale-New Haven Hospital in Connecticut, and colleagues examined and compared mortality and readmission rates among men in VA and non-VA hospitals. Data were included for male Medicare fee-for-service beneficiaries aged 65 years or older and hospitalized between 2000 and 2013 for AMI, heart failure, and pneumonia. The authors compared 30-day risk-standardized mortality rates and readmission rates for 104 VA and 1,513 non-VA hospitals.

The researchers found that, compared with non-VA hospitals, in VA hospitals mortality rates were lower for AMI (13.5 versus 13.7; P = 0.02) and heart failure (11.4 versus 11.9 percent; P = 0.008), but not for pneumonia (12.6 versus 12.2 percent; P = 0.45). For all three conditions, readmission rates were higher at VA hospitals: AMI, 17.8 versus 17.2 percent; heart failure, 24.7 versus 23.5 percent; and pneumonia, 19.4 versus 18.7 percent (all P < 0.001).

“Among older men with AMI, heart failure, or pneumonia, hospitalization at VA hospitals, compared with hospitalization at non-VA hospitals, was associated with lower 30-day risk-standardized all-cause mortality rates for AMI and heart failure, and higher 30-day risk-standardized all-cause readmission rates for all three conditions,” the authors write.

Several authors disclosed financial ties to the pharmaceutical, medical device, and health care industries.

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