{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T17:10:26Z","timestamp":1790356226898,"version":"4.1.0"},"reference-count":52,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Many veterans enrolled in the Veterans Affairs (VA) health care system have access to non-VA care through insurance and VA-purchased community care. Prior comparisons of VA and non-VA hospital outcomes have been limited to subpopulations.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To compare outcomes for 6 acute conditions in VA and non-VA hospitals for younger and older veterans using VA and all-payer discharge data.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cohort study used a repeated cross-sectional analysis of hospitalization records for acute myocardial infarction (AMI), coronary artery bypass graft (CABG), gastrointestinal (GI) hemorrhage, heart failure (HF), pneumonia, and stroke. Participants included VA enrollees from 11 states at VA and non-VA hospitals from 2012 to 2017. Analysis was conducted from July 1, 2022, to October 18, 2023.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Treatment in VA or non-VA hospital.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome and Measures<\/jats:title>\n Thirty-day mortality, 30-day readmission, length of stay (LOS), and costs. Average treatment outcomes of VA hospitals were estimated using inverse probability weighted regression adjustment to account for selection into hospitals. Models were stratified by veterans\u2019 age (aged less than 65 years and aged 65 years and older).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n There was a total of 593\u202f578 hospitalizations and 414\u202f861 patients with mean (SD) age 75 (12) years, 405\u202f602 males (98%), 442\u202f297 hospitalizations of non-Hispanic White individuals (75%) and 73\u202f155 hospitalizations of non-Hispanic Black individuals (12%) overall. VA hospitalizations had a lower probability of 30-day mortality for HF (age \u226565 years, \u22120.02 [95% CI, \u22120.03 to \u22120.01]) and stroke (age &amp;lt;65 years, \u22120.03 [95% CI, \u22120.05 to \u22120.02]; age \u226565 years,\u2009\u22120.05 [95% CI, \u22120.07 to \u22120.03]). VA hospitalizations had a lower probability of 30-day readmission for CABG (age &amp;lt;65 years, \u22120.04 [95% CI, \u22120.06 to \u22120.01]; age \u226565 years, \u22120.05 [95% CI, \u22120.07 to \u22120.02]), GI hemorrhage (age &amp;lt;65 years, \u22120.04 [95% CI, \u22120.06 to \u22120.03]), HF (age &amp;lt;65 years, \u22120.05 [95% CI, \u22120.07 to \u22120.03]), pneumonia (age &amp;lt;65 years, \u22120.04 [95% CI, \u22120.06 to \u22120.03]; age \u226565 years, \u22120.03 [95% CI, \u22120.04 to \u22120.02]), and stroke (age &amp;lt;65 years, \u22120.11 [95% CI, \u22120.13 to \u22120.09]; age \u226565 years, \u22120.13 [95% CI, \u22120.16 to \u22120.10]) but higher probability of readmission for AMI (age &amp;lt;65 years, 0.04 [95% CI, 0.01 to 0.06]). VA hospitalizations had a longer mean LOS and higher costs for all conditions, except AMI and stroke in younger patients.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cohort study of veterans, VA hospitalizations had lower mortality for HF and stroke and lower readmissions, longer LOS, and higher costs for most conditions compared with non-VA hospitalizations with differences by condition and age group. There were tradeoffs between better outcomes and higher resource use in VA hospitals for some conditions.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.45898","type":"journal-article","created":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T11:31:10Z","timestamp":1701430270000},"page":"e2345898","source":"Crossref","is-referenced-by-count":31,"title":["Outcomes of Veterans Treated in Veterans Affairs Hospitals vs Non\u2013Veterans Affairs Hospitals"],"prefix":"10.1001","volume":"6","author":[{"given":"Jean","family":"Yoon","sequence":"first","affiliation":[{"name":"Health Economics Resource Center, Veterans Affairs Palo Alto Health Care System, Menlo Park, California"},{"name":"Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Menlo Park, California"},{"name":"Department of General Internal Medicine, University of California San Francisco School of Medicine, San 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Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan E.","family":"Vanneman","sequence":"additional","affiliation":[{"name":"Informatics, Decision-Enhancement and Analytic Sciences Center, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, Utah"},{"name":"Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City"},{"name":"Division of Health System Innovation and Research, Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Chow","sequence":"additional","affiliation":[{"name":"Health Economics Resource Center, Veterans Affairs Palo Alto Health Care System, Menlo Park, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Redd","sequence":"additional","affiliation":[{"name":"Informatics, Decision-Enhancement and Analytic Sciences Center, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth W.","family":"Kizer","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew P.","family":"Dizon","sequence":"additional","affiliation":[{"name":"Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Menlo Park, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Wong","sequence":"additional","affiliation":[{"name":"Health Economics Resource Center, Veterans Affairs Palo Alto Health Care System, Menlo Park, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Zhang","sequence":"additional","affiliation":[{"name":"Informatics, Decision-Enhancement and Analytic Sciences Center, Veterans 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