Extreme Makeover: Transformation of the Veterans Health Care System
- 1 April 2009
- journal article
- review article
- Published by Annual Reviews in Annual Review of Public Health
- Vol. 30 (1) , 313-339
- https://doi.org/10.1146/annurev.publhealth.29.020907.090940
Abstract
The veterans health care system administered by the U.S. Department of Veterans Affairs (VA) was established after World War I to provide health care for veterans who suffered from conditions related to their military service. It has grown to be the nation's largest integrated health care system.As the system grew, a number of factors contributed to its becoming increasingly dysfunctional. By the mid-1990s, VA health care was widely criticized for providing fragmented and disjointed care of unpredictable and irregular quality, which was expensive, difficult to access, and insensitive to individual needs.Between 1995 and 1999, the VA health care system was reengineered, focusing especially on management accountability, care coordination, quality improvement, resource allocation, and information management. Numerous systemic changes were implemented, producing dramatically improved quality, service, and operational efficiency. VA health care is now considered among the best in America, and the VA transformation is viewed as a model for health care reform.Keywords
This publication has 124 references indexed in Scilit:
- Utilization and expenditures of veterans obtaining primary care in community clinics and VA medical centers: an observational cohort studyBMC Health Services Research, 2007
- The Veterans Health Administration: An American Success Story?The Milbank Quarterly, 2007
- Health status among 28,000 women veteransJournal of General Internal Medicine, 2006
- Performance-based budgeting in the public sector: an illustration from the VA health care systemHealth Economics, 2005
- Are Primary Care Services a Substitute or Complement for Specialty and Inpatient Services?Health Services Research, 2005
- Primary care physician time utilization before and after implementation of an electronic health record: A time-motion studyJournal of Biomedical Informatics, 2004
- Evaluation of the Department of Veterans Affairs Community-Based Outpatient ClinicsMedical Care, 2002
- The “New VA”: Delivering Health Care Value Through Integrated Service NetworksAnnals of Emergency Medicine, 1997
- Risk Adjustment of the Postoperative Morbidity Rate for the Comparative Assessment of the Quality of Surgical Care: Results of the National Veterans Affairs Surgical Risk StudyJournal of the American College of Surgeons, 1997
- Cost-effectiveness of Veterans Administration hospital-based home care. A randomized clinical trialArchives of internal medicine (1960), 1990