May 16 (UPI) -- Death rates for veterans with heart disease and chronic heart failure varied widely in the Veterans Affairs healthcare system in an analysis of medical records.
Led by Peter W. Groeneveld, a researcher at the Veterans Affairs Medical Center in Philadelphia, researchers analyzed mortality rates for ischemic heart disease and chronic heart failure across the 138 VA medical centers in the United States. Their findings were published Wednesday in the Journal of American Medicine Cardiology.
The Department of Veterans Affairs provides healthcare to more than 2 million veterans with cardiovascular disease. Cardiovascular disease includes ischemic heart failure, which is a restriction in blood supply to tissues, and chronic heart disease, which is when the heart fails to pump sufficient blood through the body, including during a heart attack.
"Differences in mortality rates among VA chronic cardiovascular disease populations may reflect differences across medical centers in the quality of care," the researchers wrote.
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The researchers said the differences could be in treatment and screening guidelines, access for urgent medical conditions, posthospitalization care protocols, chronic disease management programs, and specialty care, social work services and behavioral healthcare.
Studied were 930,079 veterans with IHD and 348,015 with CHF that received inpatient or outpatient care between 2010 and 2014. The average age patients was 77, and 89 percent of IHD patients and 83 percent of CHF were white.
Death rates varied across the VA medical centers from 5.5 percent to 9.4 percent for IHD and from 11.1 percent to 18.9 percent for CHF.
The number of cases at each medical center also varied widely -- from 1,060 to 19,955 with IHD and for CHF it ranged from 335 to 7,917.
"For more than 20 years, the VA has attempted to measure and improve healthcare quality for veterans with these conditions, yet most of these efforts have focused on either process measures of quality -- such as beta blockers for heart failure -- or surrogate clinical outcomes -- such as hypertension treatment targets," the author wrote.
But the researchers noted that while data permitting hospital comparisons of the outcomes of acute cardiovascular care are publicly available, "little is known about variation" across the VA medical centers in outcomes for chronic, high-risk cardiovascular conditions.
