Table 1.
Characteristics of Medicare Beneficiaries Hospitalized in Veterans Affairs and non-Veterans Affairs Hospitals for Acute Myocardial Infarction, Heart Failure, and Pneumonia, 2010–2013.
| Acute myocardial infarction | Heart failure | Pneumonia | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mortality | Readmission | Mortality | Readmission | Mortality | Readmission | |||||||
| VA | Non-VA | VA | Non-VA | VA | Non-VA | VA | Non-VA | VA | Non-VA | VA | Non-VA | |
| Total no. of admissions | 8,012 | 124,220 | 7,929 | 132,276 | 22,882 | 215,312 | 26,231 | 269,856 | 21,092 | 190,798 | 21,229 | 205,060 |
| Total no. of hospitals | 103 | 1,439 | 103 | 1,420 | 104 | 1,500 | 104 | 1,500 | 104 | 1,505 | 104 | 1,506 |
| Demographics | ||||||||||||
| Age, mean (SD), y | 76.2 (8.4) | 77.8 (8.0) | 75.5 (8.1) | 77.5 (7.9) | 77.3 (8.4) | 80.0 (8.1) | 77.0 (8.3) | 79.7 (8.0) | 77.9 (8.5) | 79.8 (8.1) | 77.5 (8.4) | 79.6 (8.1) |
| Race, % | ||||||||||||
| White | 77.0 | 86.1 | 84.4 | 86.4 | 72.6 | 82.4 | 78.8 | 81.6 | 78.3 | 85.2 | 86.1 | 85.2 |
| Black | 11.4 | 7.9 | 12.1 | 7.9 | 15.9 | 12.0 | 18.4 | 12.8 | 10.2 | 8.3 | 11.1 | 8.3 |
| Other | 3.1 | 5.8 | 3.3 | 5.5 | 2.6 | 5.4 | 2.7 | 5.5 | 2.7 | 6.4 | 2.6 | 6.3 |
| Unknown | 8.5 | 0.2 | 0.2 | 0.2 | 8.9 | 0.1 | 0.2 | 0.1 | 8.8 | 0.2 | 0.2 | 0.2 |
| Cardiovascular medical history, % | ||||||||||||
| History of PCI | 12.8 | 18.1 | 14.7 | 19.7 | 7.3 | 15.5 | -- | -- | 3.8 | 9.5 | -- | -- |
| History of CABG | 17.1 | 14.2 | 17.2 | 14.1 | 17.6 | 25.5 | 18.5 | 26.5 | 7.7 | 14.0 | 8.0 | 14.1 |
| Heart failure | 32.8 | 29.2 | 34.6 | 31.4 | 77.7 | 76.4 | 80.7 | 78.9 | 33.7 | 39.2 | 35.4 | 39.3 |
| Anterior myocardial infarction | 3.7 | 9.0 | 3.2 | 7.8 | -- | -- | -- | -- | -- | -- | -- | -- |
| Inferior, lateral, or posterior myocardial infarction | 5.9 | 13.3 | 5.7 | 12.0 | -- | -- | -- | -- | -- | -- | -- | -- |
| Acute coronary syndromes | 23.1 | 20.2 | 25.0 | 22.6 | 14.9 | 18.0 | 16.2 | 19.2 | 6.8 | 8.9 | 7.4 | 8.9 |
| Coronary atherosclerosis | 85.7 | 88.9 | 88.5 | 91.5 | 74.7 | 81.9 | 77.0 | 83.4 | 47.5 | 58.6 | 49.0 | 58.7 |
| Cardiopulmonary-respiratory failure and shock | 9.3 | 9.5 | -- | -- | 19.3 | 25.5 | 21.5 | 27.0 | 17.8 | 21.9 | 20.3 | 22.5 |
| Valvular heart disease | 19.1 | 29.5 | 19.1 | 30.2 | 32.2 | 52.4 | 33.7 | 53.5 | -- | -- | 14.2 | 26.8 |
| Arrhythmia | -- | -- | 34.8 | 37.2 | -- | -- | 67.9 | 73.1 | -- | -- | 42.0 | 50.0 |
| Other unspecified heart disease | -- | -- | -- | -- | -- | -- | 21.7 | 33.8 | -- | -- | -- | -- |
| Comorbid conditions, % | ||||||||||||
| Hypertension | 92.7 | 86.3 | -- | -- | 94.3 | 91.5 | -- | -- | 86.1 | 85.6 | -- | -- |
| Stroke | 10.4 | 7.5 | 10.5 | 7.4 | 11.4 | 10.0 | 11.5 | 10.0 | 11.1 | 10.6 | 11.2 | 10.5 |
| Cerebrovascular disease | 16.6 | 20.7 | 17.2 | 21.0 | -- | -- | -- | -- | 16.6 | 24.3 | -- | -- |
| Renal failure | 34.3 | 27.0 | 35.4 | 28.3 | 52.6 | 53.5 | 55.2 | 55.3 | 32.6 | 34.0 | 33.7 | 34.0 |
| Chronic obstructive pulmonary disease | 31.7 | 29.4 | 32.8 | 29.8 | 51.0 | 48.8 | 53.3 | 49.4 | 59.1 | 54.1 | 61.3 | 54.4 |
| Pneumonia | 20.8 | 23.1 | 20.6 | 22.5 | 32.0 | 45.5 | 33.5 | 45.7 | 39.8 | 42.8 | 43.0 | 44.0 |
| Diabetes | 55.1 | 46.9 | 56.4 | 47.6 | 60.8 | 55.5 | 61.8 | 56.3 | -- | -- | 44.5 | 44.9 |
| Protein-calorie malnutrition | 3.6 | 6.3 | 3.6 | 5.9 | 4.7 | 10.4 | 4.8 | 9.8 | 8.3 | 14.3 | 8.6 | 13.6 |
| Dementia | 16.2 | 17.3 | 14.8 | 16.7 | 17.7 | 22.5 | 17.3 | 21.8 | 26.5 | 30.2 | 25.9 | 29.8 |
| Functional disability | 8.9 | 6.6 | 9.1 | 6.6 | 9.1 | 9.2 | 9.1 | 9.2 | 10.1 | 10.3 | 10.4 | 10.3 |
| Peripheral vascular disease | 28.8 | 28.6 | -- | -- | 34.2 | 42.1 | -- | -- | 28.3 | 35.8 | -- | -- |
| Metastatic cancer | 5.3 | 4.7 | 2.7 | 2.5 | 4.7 | 5.6 | 27.1 | 27.1 | 12.8 | 12.5 | 32.0 | 29.6 |
| Trauma in last year | 29.6 | 28.4 | -- | -- | 34.4 | 38.5 | -- | -- | 35.1 | 38.9 | -- | -- |
| Major psychiatric disorders | 11.7 | 6.9 | -- | -- | 12.3 | 9.6 | 12.8 | 9.7 | 17.0 | 12.8 | 17.2 | 12.9 |
| Chronic liver disease | 2.4 | 1.7 | -- | -- | 4.7 | 3.8 | 10.8 | 12.6 | 3.3 | 2.7 | -- | -- |
| Severe hematological disorders | -- | -- | -- | -- | -- | -- | 3.2 | 4.4 | 3.1 | 4.8 | 3.3 | 4.6 |
| Iron deficiency | -- | -- | 41.9 | 45.6 | -- | -- | 55.4 | 62.6 | 52.8 | 58.9 | 53.5 | 58.5 |
| Depression | -- | -- | -- | -- | -- | -- | 21.2 | 15.5 | 23.6 | 17.9 | -- | -- |
| Seizure disorders or convulsions | -- | -- | -- | -- | -- | -- | -- | -- | 5.2 | 6.6 | -- | -- |
| Fibrosis of lung or other chronic lung disorders | -- | -- | -- | -- | -- | -- | 7.8 | 12.2 | 10.7 | 16.7 | 11.2 | 16.8 |
| Asthma | -- | -- | 3.5 | 5.3 | -- | -- | 4.3 | 7.7 | 5.2 | 9.0 | 5.4 | 9.3 |
| End-stage renal disease | -- | -- | 3.6 | 3.8 | -- | -- | 1.9 | 5.7 | -- | -- | 2.5 | 4.4 |
| Nephritis | -- | -- | -- | -- | -- | -- | 4.2 | 4.4 | -- | -- | -- | -- |
| Urinary tract infection | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | 18.5 | 19.7 |
| Urinary tract disorders | -- | -- | 19.1 | 24.7 | -- | -- | 27.1 | 38.2 | -- | -- | 21.8 | 29.8 |
| Pleural effusion/pneumothorax | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | 11.5 | 19.1 |
| Other lung disorders | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | 34.1 | 47.6 |
| Fluid and electrolyte disorders | -- | -- | 25.8 | 26.1 | -- | -- | 41.5 | 47.7 | -- | -- | 35.5 | 40.2 |
| Other psychiatric disorders | -- | -- | -- | -- | -- | -- | 16.3 | 12.8 | -- | -- | 18.8 | 14.2 |
| Drug/Alcohol abuse | -- | -- | -- | -- | -- | -- | 23.5 | 15.5 | -- | -- | 26.8 | 16.7 |
| Peptic ulcer and other specified GI disorders | -- | -- | -- | -- | -- | -- | 13.7 | 15.6 | -- | -- | -- | -- |
| Other GI disorders | -- | -- | -- | -- | -- | -- | 58.9 | 58.2 | -- | -- | 64.7 | 61.8 |
| Parkinson’s and Huntington’s Diseases | -- | -- | -- | -- | -- | -- | -- | -- | 4.1 | 5.3 | -- | -- |
| Vertebral fractures | -- | -- | -- | -- | -- | -- | -- | -- | 2.2 | 3.8 | 2.2 | 3.8 |
| Other injuries | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | 34.5 | 37.0 |
| Decubitus skin ulcer | -- | -- | 8.6 | 7.7 | -- | -- | 14.3 | 16.0 | -- | -- | 10.7 | 12.6 |
| Other history of infection | -- | -- | 27.9 | 25.6 | -- | -- | -- | -- | -- | -- | 37.4 | 39.6 |
| Septicemia/Shock | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | 7.8 | 10.0 |
| Percent of patients hospitalized in both VA and non-VA hospitals | 0.06 | 0.97 | 0.27 | 2.07 | 0.13 | 1.55 | ||||||
| Percent of patients discharged alive who died without being readmitted within 30 days, % | N/A | 4.4 | 4.5 | N/A | 4.6 | 5.6 | N/A | 6.0 | 6.0 | |||
| Percent of patients readmitted to non-VA hospitals within 30 days among those initially hospitalized in VA hospitals, % | N/A | 11.4 | N/A | 14.1 | N/A | 12.2 | ||||||
| Percent of patients readmitted to VA hospitals within 30 days among those initially hospitalized in non-VA hospitals, % | N/A | 0.3 | N/A | 0.3 | N/A | 0.3 | ||||||
PCI: percutaneous coronary intervention; CABG: coronary artery bypass graft; y: years; N/A: not applicable
“—”: Not included in risk-adjustment of publicly-reported measures for a given condition and outcome