Health-Related Quality of Life in Patients Served by the Department of Veterans Affairs

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Abstract
THE DEPARTMENT of Veterans Affairs Health Care System (VA) is a federally funded integrated system of care, with about 5% of the total market share for hospital services.1 It serves a select group of veterans, with complex health care needs. Compared with veterans nationally and the general US population, users of the VA health care system not only have disabilities that are connected to their military service but they are also older, poorer, less educated, and sicker with more disease.2,3 Lessons learned from the VA can provide a model for monitoring the outcomes of care in other managed care systems, especially those serving older populations. Like other health care systems that are seeking to adapt to a changing health care environment, the VA needs information about the health of current and prospective patients to anticipate patient demand, design effective services, and evaluate the outcomes of its care. The information that the VA has at hand to guide providers of care, administrators, and policymakers regarding ambulatory care is limited. In response to these needs, the Veterans Health Study (VHS) was developed to implement and demonstrate the use of monitoring patient-derived measures of functional status in the VA.