Diabetes patients fare better under US nationally funded health care system

Nearly a decade after the Department of Veterans Affairs (VA) initiated expansive improvements in how it cares for veterans with chronic illnesses, a new multicenter study finds VA patients with diabetes are more likely to receive recommended tests and have better outcomes than managed care patients.

Researchers looked at 1,285 patients with diabetes from five VA medical centers and 6,920 patients in eight commercial managed care health plans. They compared how often patients received standard processes of care, such as recommended tests, and their outcomes related to diabetes control.

The VA patients fared better than managed care patients on receiving appropriate care and on two of three outcomes, and in many cases the differences in quality were large.

The managed care plans assessed in this study are among the best, with diabetes quality results near the top compared to all managed care plans accredited by the National Committee for Quality Assurance. Each commercial plan and VA medical center represents patients in a specific geographic area: Central Indiana, Northern California, Southern Texas, New Jersey and Pennsylvania, and Southeastern Michigan.

The study will be published Aug. 17 in the Annals of Internal Medicine, writes Newswise.

The Detroit Times is reporting that “the VA has made great strides in the past 10 years,” said Eve A. Kerr, the study's lead author, who is a physician and research scientist at the VA Ann Arbor Healthcare System and assistant professor of internal medicine at the University of Michigan Medical School. “What this tells us is that a nationally funded health care system can provide excellent quality of care.”

Compared with their managed-care counterparts, diabetes patients treated by VA doctors more often received the recommended annual blood tests (93 percent vs. 83 percent), eye exams (91 percent vs. 75 percent) and foot exams (98 percent vs. 84 percent).

The VA group also received more cholesterol testing (79 percent vs. 63 percent) and had better control of their cholesterol levels as a result, according to the study.

Forbes adds that "a nationally funded health-care system can provide excellent quality of care. The VA has instituted system-wide standards, integrated care, and a way to track and monitor how their patients are doing. Other organizations can learn from the VA and how they achieved their quality improvements over the last 10 years," study author Dr. Eve Kerr, a research scientist at the VA Ann Arbor Healthcare System and an assistant professor of internal medicine at the University of Michigan Medical School, said in a prepared statement.