Evaluation of veteran community care outcomes after coronary artery bypass grafting: a retrospective pilot cohort
Abstract For Veterans who cannot be seen in a timely fashion or must travel long distances to be seen, the Veterans Health Administration (VHA) offers funded care in the community. The use of this program has rapidly increased; however, there have been no systematic evaluations of surgery specific m...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-03-01
|
| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-024-02644-8 |
| _version_ | 1827300872610119680 |
|---|---|
| author | Jake L Cotton Adom Netsanet Alejandro Suarez-Pierre Danielle Abbitt Teresa S Jones Jessica Y Rove Edward L Jones |
| author_facet | Jake L Cotton Adom Netsanet Alejandro Suarez-Pierre Danielle Abbitt Teresa S Jones Jessica Y Rove Edward L Jones |
| author_sort | Jake L Cotton |
| collection | DOAJ |
| description | Abstract For Veterans who cannot be seen in a timely fashion or must travel long distances to be seen, the Veterans Health Administration (VHA) offers funded care in the community. The use of this program has rapidly increased; however, there have been no systematic evaluations of surgery specific metrics such as perioperative complications, mortality and timeliness of care. To evaluate this in cardiac surgery patients, we compared veterans undergoing coronary artery bypass grafting in the community to those remaining within the VHA. We identified 78 patients during calendar year 2018 meeting inclusion criteria. 41 underwent surgery in the community versus 37 in the VHA. There were no significant differences in baseline demographics including age, sex, race, ethnicity, comorbidities and surgical risk scores. With regard to perioperative outcomes, veterans who underwent surgery within the VHA had lower infection rates (17% vs. 0%, p = 0.008) and 30-day emergency department utilization (22% vs. 5%, p = 0.04). A longer median postoperative inpatient stay was also seen within the VHA (8 days vs. 6 days, p < 0.001). These findings suggest that the VHA may better serve Veterans and prevent adverse events after CABG, at the expense of prolonged hospitalization. More study is needed to validate the findings of this pilot study. |
| first_indexed | 2024-04-24T16:13:31Z |
| format | Article |
| id | doaj.art-a02da6c24fef4111a5ee26e739251e52 |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-04-24T16:13:31Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-a02da6c24fef4111a5ee26e739251e522024-03-31T11:35:10ZengBMCJournal of Cardiothoracic Surgery1749-80902024-03-011911410.1186/s13019-024-02644-8Evaluation of veteran community care outcomes after coronary artery bypass grafting: a retrospective pilot cohortJake L Cotton0Adom Netsanet1Alejandro Suarez-Pierre2Danielle Abbitt3Teresa S Jones4Jessica Y Rove5Edward L Jones6Department of Surgery, University of Colorado School of MedicineDepartment of Surgery, University of Colorado School of MedicineDepartment of Surgery, University of Colorado School of MedicineDepartment of Surgery, University of Colorado School of MedicineDepartment of Surgery, Rocky Mountain Regional VA Medical CenterDivision of Cardiothoracic Surgery, Department of Surgery, University of Colorado School of MedicineDepartment of Surgery, Rocky Mountain Regional VA Medical CenterAbstract For Veterans who cannot be seen in a timely fashion or must travel long distances to be seen, the Veterans Health Administration (VHA) offers funded care in the community. The use of this program has rapidly increased; however, there have been no systematic evaluations of surgery specific metrics such as perioperative complications, mortality and timeliness of care. To evaluate this in cardiac surgery patients, we compared veterans undergoing coronary artery bypass grafting in the community to those remaining within the VHA. We identified 78 patients during calendar year 2018 meeting inclusion criteria. 41 underwent surgery in the community versus 37 in the VHA. There were no significant differences in baseline demographics including age, sex, race, ethnicity, comorbidities and surgical risk scores. With regard to perioperative outcomes, veterans who underwent surgery within the VHA had lower infection rates (17% vs. 0%, p = 0.008) and 30-day emergency department utilization (22% vs. 5%, p = 0.04). A longer median postoperative inpatient stay was also seen within the VHA (8 days vs. 6 days, p < 0.001). These findings suggest that the VHA may better serve Veterans and prevent adverse events after CABG, at the expense of prolonged hospitalization. More study is needed to validate the findings of this pilot study.https://doi.org/10.1186/s13019-024-02644-8Veterans healthPatient outcome assessmentCoronary artery bypassVHA |
| spellingShingle | Jake L Cotton Adom Netsanet Alejandro Suarez-Pierre Danielle Abbitt Teresa S Jones Jessica Y Rove Edward L Jones Evaluation of veteran community care outcomes after coronary artery bypass grafting: a retrospective pilot cohort Journal of Cardiothoracic Surgery Veterans health Patient outcome assessment Coronary artery bypass VHA |
| title | Evaluation of veteran community care outcomes after coronary artery bypass grafting: a retrospective pilot cohort |
| title_full | Evaluation of veteran community care outcomes after coronary artery bypass grafting: a retrospective pilot cohort |
| title_fullStr | Evaluation of veteran community care outcomes after coronary artery bypass grafting: a retrospective pilot cohort |
| title_full_unstemmed | Evaluation of veteran community care outcomes after coronary artery bypass grafting: a retrospective pilot cohort |
| title_short | Evaluation of veteran community care outcomes after coronary artery bypass grafting: a retrospective pilot cohort |
| title_sort | evaluation of veteran community care outcomes after coronary artery bypass grafting a retrospective pilot cohort |
| topic | Veterans health Patient outcome assessment Coronary artery bypass VHA |
| url | https://doi.org/10.1186/s13019-024-02644-8 |
| work_keys_str_mv | AT jakelcotton evaluationofveterancommunitycareoutcomesaftercoronaryarterybypassgraftingaretrospectivepilotcohort AT adomnetsanet evaluationofveterancommunitycareoutcomesaftercoronaryarterybypassgraftingaretrospectivepilotcohort AT alejandrosuarezpierre evaluationofveterancommunitycareoutcomesaftercoronaryarterybypassgraftingaretrospectivepilotcohort AT danielleabbitt evaluationofveterancommunitycareoutcomesaftercoronaryarterybypassgraftingaretrospectivepilotcohort AT teresasjones evaluationofveterancommunitycareoutcomesaftercoronaryarterybypassgraftingaretrospectivepilotcohort AT jessicayrove evaluationofveterancommunitycareoutcomesaftercoronaryarterybypassgraftingaretrospectivepilotcohort AT edwardljones evaluationofveterancommunitycareoutcomesaftercoronaryarterybypassgraftingaretrospectivepilotcohort |