December 28, 2000New England Journal of Medicine
Outcome of Myocardial Infarction in Veterans Health Administration Patients as Compared with Medicare Patients
Why the study?
Does care in Veterans Health Administration (VHA) hospitals reduce 30-day and 1-year mortality in men at least 65 years of age with acute myocardial infarction compared to non-VHA institutions?
Population
31,735 men at least 65 years of age discharged with confirmed acute myocardial infarction
Comparison
Care in Veterans Health Administration hospitals vs Care in non-VHA institutions (Medicare patients)
Design
Cohort
Follow-up
1 year
Authors
Discussion
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Member takes
Implication
Similar mortality supports care equivalence in VHA versus non-VHA settings for older men with AMI; leaves open causal effects due to residual confounding.
Structured PICO
Does care in Veterans Health Administration (VHA) hospitals reduce 30-day and 1-year mortality in men at least 65 years of age with acute myocardial infarction compared to non-VHA institutions?
P
Population
31,735 men at least 65 years of age discharged with confirmed acute myocardial infarction (2,486 veterans from 81 VHA hospitals and 29,249 Medicare patients from 1,530 non-VHA hospitals)
I
Intervention
Care in Veterans Health Administration (VHA) hospitals
C
Comparator
Care in non-VHA institutions (Medicare patients)
O
Outcome
30-day and 1-year mortalityhard clinical
Despite having a higher burden of coexisting conditions, older men with acute myocardial infarction treated in VHA hospitals have similar 30-day and 1-year mortality compared to those treated in non-VHA hospitals.
Cite This Study
Petersen et al. (2000) studied this question.