I’ve known for a long time that we in VA have some of the most skilled and dedicated health care professionals in the nation. I also know our hospitals use some of the best technology around, and that our model of integrated care is second to none.

Now we have yet another major research study that attests to those facts. This one has to do with an area I am intimately familiar with – emergency care. This is a branch of VA care that is often a matter of life and death for our Veterans.

Main finding: 20% or better survival advantage

The new study appeared last week in the prestigious British Medical Journal (BMJ). It was carried out by researchers from VA, Stanford University, Carnegie Mellon University and the University of California, Berkeley. The funding came from VA, Stanford and the National Institutes of Health.

The big finding of the study was that Veterans who needed emergency care and were rushed by ambulance to a VA hospital, versus a non-VA hospital in the community, had lower mortality rates. Their survival rates were at least 20% better at the one-month mark.

VA doctor Troy Sommerville discusses with a Veteran his “Journey to Discharge” from the VA medical center. (Photo taken pre-pandemic)

The survival advantage was even bigger for minority groups. Black Veterans seen in VA emergency care were nearly 25% less likely to die within 30 days. For Hispanic Veterans, the survival edge was nearly 23%.

Study looked at 1.4 million emergency visits

The study looked at data on about 583,000 Veterans over age 65 who were taken by ambulance to emergency departments – either at VA or non-VA hospitals – between 2001 and 2018. In all, there were some 1.4 million ambulance rides. All the Veterans in the study were enrolled in both VA and Medicare.

Check out this infographic for a quick snapshot of the study.

The value of integrated care

Another important finding: Mortality rates were also lower for Veterans who were taken to hospitals where they had previously received care. This says something about the value of our integrated care system.

More than nine million Veterans are enrolled in VA care. Today, more options are available to Veterans on where to get care and that’s a good thing. But we still urge Veterans to choose VA care. That’s because we believe our 171 hospitals and 1,112 clinics do an excellent job of caring for Veterans.

Part of that is our amazing staff, many of whom are Veterans themselves. Not only are they highly skilled at what they do but they care deeply about Veterans and the VA mission.

Besides our people, another crucial factor is our system. Though our network is huge – the nation’s largest integrated health care system – we’re very good at having all the different parts talk to each other. Credit our state-of-the-art information technology, among other organizational factors.

Most studies on the topic have shown that Veterans who receive all their care – from primary care to specialty care – under “one roof,” so to speak, have better health outcomes. That may help explain, in part, some of these new findings on emergency care.

A learning health care system

We’ll use the results of this research to further optimize emergency care for Veterans, both within VA and in the community.

At our core, we’re a learning health care system. We put ourselves under the microscope. We study ourselves in an unbiased, rigorous way (Many universities and outside organizations study us as well.).

That was the case in this study, funded in part by the VA Office of Research and Development. It has also been the case in many other published studies analyzing VA care and comparing outcomes. To some people’s surprise, we generally outperform, or at least match, the private sector.

Whatever the outcomes of any one study, we’re always learning from our success and our failures, striving to do better all the time. We owe it to the Veterans we serve.

By Chad Kessler, M.D., M.B.A., is VA’s national director for Emergency Medicine and a professor of medicine at Duke University School of Medicine in Durham, North Carolina. Photo by Dwayne Rider, public affairs officer for the Hershel "Woody" Williams VA Medical Center.

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Published on Feb. 22, 2022

Estimated reading time is 3.4 min.

Views to date: 2,782

18 Comments

  1. Melva Marsha Powell March 5, 2022 at 7:00 pm

    My father died in 1998 from an overdose of Heparin he received in the VA Medical Center Emergency Room. He was left unattended for hours until a Nurse heard my father complaining of a severe headache. A CT scan revealed he suffered massive hemorrhaging in his brain from Heparin. He died four days later, and the autopsy report said the cause of death was due to the medication therapy and a botched Brain Surgery done by an unsupervised Resident.

    His brother died twenty years later in 2018 at the same VA Medical Center. His cause of death was Stage 4 Pancreatic cancer. The VA found a small carcinoma in his stomach in 2015, and he began treatment right away. In January 2017, he was Cancer Free and in remission the entire year. The VA is known for making Veterans wait for months for doctor’s appointments. By the time my uncle got a follow-up appointment at the VA in July 2018, he was told he had six months left to live because the VA kept posting his appointments. I buried my uncle in December 2018, the night before his big birthday celebration at his Church. It was an event he began planning on his last birthday.

    The point of my story is the VA has helped to save the lives of many Veterans for decades. Still, they have also caused many veterans to die from medical errors and intentional harm by bad employees who falsify medical records and omit their mistakes. VA Medical Centers only report to the public about the successful medical care and treatments, while they cover up the deaths like they did my father that was caused by negligent care.
    It will be twenty-four years in July and I still don’t know what happened to my father. The VA needs to do more to protect our Veterans.

  2. Vivian March 4, 2022 at 9:10 am

    The iron mountain VA doesn’t even have an emergency room for over 5 years now. My husband went there for chest pains, they have an urgent care, gave him nitro and baby aspirin and sent him to dickenson county hospital. This started a week in hell. He ended up in Aurora hospital eventually and had 7 or 8 stints put in his heart. Now he no longer has a doctor in the VA clinic in Menominee Michigan.

  3. Sean Higgins March 4, 2022 at 8:07 am

    This is such bullsht! This is nothing more than more lies from the WORST agency in the US government. If this story were remotely true. How is it that this occurred during the same time frame. The lying Mfers at VA killed 16 Veterans in one years ALL WERE PREVENTABLE! No one went to jail or was held accountable.

    https://www.fox13memphis.com/news/local/16-patients-died-unnecessarily-at-memphis-va-hospital-report-says/773358410/

  4. Eugene garcia March 4, 2022 at 1:00 am

    I went to the denver VA for knee problems. They took to running every test unde the sun. First the didn’t address my knee problems. They instead tell me I have high blood pressure and high cholesterol. So they prescribe medicine that us very unhealthy for people of color. Rhen when they do finally get to my knee issues. They tell me I have osteoarthritis. And the first dr said I wod have to get a knee replaced. Then they say I have atorn meniscus. And mind you every dr I see is a different one each time. Finally a dr calls me and says over the phone. That I don’t need a knee replacement. And im too heavy. He’s never seen me. All he goes by is what’s written down on a chart. I can guarantee I’m in better shape than most of the doctors that saw Me. Then he continues to give me a bunch of other excuses. One being Mt bmi is too high. The cutoff for surgery is a bmi of 35. Mine was 35 5. And then they have the audacity to tell me take Tylenol for the pain. And only prescribe tramadol. 30 count at that. Im so beyond tired of going back and forth.

  5. Ernie Howe March 3, 2022 at 4:35 pm

    Yep, tye VA said it, so it MUST be true? BS!
    Tell that to the vet Asheville killed in Sept. 2016i.
    22 year vet, moved to NC with his family, new house, new life. I think he had some pain, so the Asheviile VA ER shot him up with 4 times the dosage with Daladen (sp?) 2 hours later, another shot 4 times the dosage. Dead. Veteran for 7 days after 32 years of service & 1st business ever to a VA & left in a body bag. The VA settled with his wife, but she hadbto sign a non-disclosure agreement. She did & the VA’s statement was the VA, Chief of Staff & Medical Center assumed ANY responsibility for that man’s death. So please explain how this man died of an overdose at the VA’s ER, with a VA syringe. VA drugs, and not even mentioning he would have to set an alarm to wake up from the 1st shot to give himself the 2nd injection?? And, AND, the Charles George VA M3d Ctr kept their 5 star rating! All on a Charlotte CBS news station here in Charlotte.
    It’s YOUR CHOICE. but this comes from a System designed to protect the System & grow. Veterans are just a tool used to keep an out of co trol govt. agency that politicians on both sides are afraid of!
    Ask your political rep why VA Healthcare meets all requirements for the Affordable Care Act & Part D ( Meficare Drug Plan ), but DOES NOT meet the minimum requirements for Medicare? So seniors get the Best Care Available, which they are entitled too, but VA care does meet their minimum? Why. Because if it did, the we vets could throw the appropriate single finger salute as we go to Medicare. You k ow where we can pick our own doctors who keep our business thru integrity & professionalism instead like vets are herded into a corrupt govt. System called the VA. Ask why VA care does NOT meet the requirements for Part B.Medicate. Bet you won’t get an honest answer.
    2nd rate doctors who cannot make it in the real world, so the hide their incapabilities under the protection of being a govt. employee.
    Like the Indiana VA Ortho surgeon who, “BOTCHED” (VA IG’s words now), BOTCHED 147 surgeries on vets feet an anklets. On your job, could you make 147 MISTAKES & still have a job?? And that’s not even countng the pain & suffering this so called doctor caused! And what did the VA do you ask.. Probation. Fckin’ probation. That’s the VA Healthcare system!

  6. Kevin J Clark February 27, 2022 at 5:53 pm

    I agree with you. On August 9th 2021 while conducting physical therapy at the VA clinic on Jefferson Street in Jacksonville Florida I fell and sustained several injuries. After the fall I didn’t receive any medical treatment. I was just sent home. On November 23rd 2021 I was told by a neurologist at a community hospital that I was suffering from rotator cuff issues. It wasn’t until January 26, 2022 that I was given a MRI. On January 28th I was informed by the VA clinic that have a massive torn rotator cuff. For the past 6 months I went about my daily life with a massive torn rotator cuff and didn’t even know it. I pray that this never happens to another Veteran.

  7. Robert Dixon February 27, 2022 at 10:05 am

    Boy oh boy! This article is misleading. Not all vets are treated this way. I am service connected 100% p and t. Vietnam combat vet. I arrived at the Durham NC VA ER because I was screaming to urinate . The nurse was great and put me in a room. Someone did an ultrasound on me. The ER doctor Abdul Khan came in and said he couldn’t find the ultrasound results. I told him I was screaming to urinate and he said it was a prostrate bladder problem. Told me the Urology department doctors were too busy to see me. He gave me 2 bottles of pills, one I was already taking and one I couldn’t take because of my heart condition. In closing, the doctor said that the Urology department would call me when they had time to see me. I said this is ridiculous, I am in serious pain. I ran out of there and went to another hospital ER and they fixed the problem. Then there was a VA hospital town hall meeting for the Durham VA hospital. I attended. They broke us up in groups guarded by people in black uniforms and armed with 9 mms. They asked me why I was there. I said I was there to complain about my ER visit. They sat me down in a chair in a hallway. Now there were TV cameras all over the place because of many complaints. A lady walked up to me with a man behind her and 2 TV reporters following her. The lady was in charge of the Durham VA hospital. She sat down next to me and I was in the middle of telling her about my experience with the Durham VA ER with the TV cameras on me. She told them to turn off the cameras immediately or they would have to leave. In closing she said she would get back to me which never happened. In the weeks before my ER visit on our local news there were stories and pictures of vets lying on the floor in the VA ER. The reporters were not allowed on the VA property after that video came out. So I am very reluctant to go to this VA hospital but they make me show up once a year to make sure I am still alive. I seek outside medical care from then on. I am sure there are some good stories but this is one of the bad ones.

  8. Suffering Vets February 26, 2022 at 12:18 pm

    I believe Ann Arbor VA ER doctors likely give you a higher chance especially when it comes to PMR care because you won’t get treatment or respect from their outpatient services and Advocates were instructed in December 2019 and in the lockdown of 2020 to stop logging complaints and grievances relating to Ann Arbor PMR. Patients appropriately making multiple complaints to the Service POC, administrative officers and advocates were placed in the program for criminals and violent patients. The service would go through patient records making deletions, adding amendments and notes to previous encounters then using those as evidence against the veterans making complaints.

    When veterans records are so corrupted I am not sure how we are supposed to believe the results of these studies but I can say from personal experience VA Ann Arbor ER has some good doctors but the system leadership, staff and PMR service is never to be trusted. I wish I could use their ER but last time I was there the VA police and violence prevention threatened me with criminal charges.

  9. Glenn Timpe February 24, 2022 at 8:51 pm

    Untrue, I personally suffered a full blown rip of the pettela, and was taken to the Ann Arbor, MI VA after hours, where I was given an x-ray and sent home with a week worths of Percocet and told orthopedics would contact me. I got in 30 days later, after completing an MRI and my PCP told me, I needed Emergency Surgery, they use U of M students in place of Doctors, the student told me to bend my legg, I said I couldn’t, she said I was uncooperative and she could not find my MRI, They told me to come back in 30 days, when I went back, they said they didn’t have an experienced Doctor available, which I was sent home again, I complained to the advacat, they gave me another appointment with and actual Doctor, who said I had a full blown tear and not to bend my legg he apologized and said the student who initially seen me was one of the bad ones and set me up with a ultrasound. I was placed in a legg brace and never received surgery or pain medication, it healed disfigured. Do not use the VA. The Ann Arbor MI, VA is a Training facility for UofM. They are incompetent and cover up malpractice. They falsify medical records and discourage further treatment if you complain.

    • Tired Vet February 26, 2022 at 8:42 am

      Glenn you’re one of many that Ann Arbor PMR has injured and retaliated against after reporting the problems. As soon as possible request through Ann Arbor VA FOIA officer a copy of your complete PATS R, it shouldn’t cost a dime. That is the record along with the disruptive behavior system and institution outlook/email systems that they use store records on patients who have complained about malpractice or crimes. Only ask for PATS R first, the DBC records for yourself can cost over 10k to FOIA.
      Since you already made a report about them I suggest you find a different PMR team to deal with as they will continue to escalate reprisals and make false reports until your driven away. They will use the VA police on you to investigate you if you continue to report providers errors and make a clinical decision that you are a violent threat and put you on a secret disruptive behavior order and flag your government records.

      To insure you can’t recover from thier retaliation they wont provide a required document you need to correct thier errors, you only have 30 days to fix these permanent records after they put you on it, after 30 days it is forever. The homeless and struggling veterans around our area are terrified of the VA and for good reason. Stay safe and know you are not alone in being harmed and abused by Ann Arbor VA and University of Michigan PMR program.

      H

  10. P. Renz February 24, 2022 at 6:39 pm

    All ambulances divert to closest ER. To the many Veterans who live 10, 20, 40 or more miles from our VA hospital this article means nothing.

    The hospital I live closest to is very likely to kill me because it is such an awful hospital. They almost killed my son.

  11. Alyce Knaflich February 24, 2022 at 8:33 am

    Charles George VAMC in Asheville, NC also diverts ambulances from their ED. Even though the veteran specifically states they are a veteran and prefer to go to the local VAMC. The ambulance rescue personnel calls the VAMC and the VAMC ED says they are not taking any patients “DIVERT”. This seems to be a systemic VAMC issue across the country according to the other comments about this article.

  12. Alyce Knaflich February 24, 2022 at 8:15 am

    Charles George VAMC in Asheville, NC also diverts ambulances from their ER even when the veteran specifically states that they are a veteran and prefer to go to the local VAMC. The medical rescue personnel calls the VAMC ED and the ED tells the ambulance that they are not taking any patients “DIVERT”. This seems to be a systemic VAMC policy across the country according to other comments to this published article.

  13. Donald Ray shipman February 23, 2022 at 8:02 pm

    Ambulances in Dallas TX WILL NOT TAKE A PERSON TO THE VA EMERGENCY ROOM! They will only deliver to hospitals with Trauma Centers which the Dallas VA does not have

    Dallas ambulances approach $1900.00, even for a three block ride. The Veteran’s problems then are to get the VA to pay for that fee. It is problematic.

    My personal experiences with two different ‘Trauma enabled hospitals” is that they really pile on with revenue generating acts of service. Again VA payment is ptoblematic. The ambulance service also chooses the hospital, the vet has no option. I do submit the service, along with that of the the EMTs is excellent @ $1900.00.

    As an aside, I have been served by the Dallas VA ER which did provide excellent care.

  14. Scott Phillips February 23, 2022 at 1:55 pm

    Thank you to all of the professional people that work at the VA facilities. You “ARE” the best!!!!

  15. Melinda February 23, 2022 at 10:33 am

    I have only read the headline, that being said. My VA hospital does not receive ambulances, so any veteran who calls for an ambulance and requests to be taken to the VA is out of luck. Next concern, I have sent secure messages to my PCP at my VA about issues that are concerning to me, hoping to be given an appointment so I could be checked out, only to be told by my PCP “if it gets worse, go to the nearest E.D.”. This clearly and unequivocally tells me that my PCP can’t be bothered to see me. My hopes for preventive care for an issue before it gets so bad that I need to go to the nearest E.D. are dashed. So this story is a load of rubbish. We clearly have a much better chance to be seen in the civilian sector than at VA.

  16. Kevin Sykes February 22, 2022 at 10:30 pm

    What were the diversion rates and for what presenting conditions and did that habe anything to do with mortality rates?

    I’m guessing yes considering most VAs divert.

    Also when speaking about increased survival rated for minorities were the diversion rates looked at… as well as for the location and access to care?

  17. Arnold Cabral February 22, 2022 at 7:41 pm

    Veterans who read this please Spread my belief the Senator office told me that Federal Agency personnel can email your Senators or your Representative their belief how to improve Veteran Medical Centers and my belief that the Veteran Affairs Committee should have a Dentist knows how to put in G4implants for free if they are 100 percent service connected because they don’t have one works for a Veteran Medical Centers Dentistry or have a contract with a Veteran Affairs Administration and if a Disabled Veterans who is 100percent service connected don’t get the G4implants it will definitely cause real bad Swallowing Problems and really bad Heart Problems and really bad Gum Disease…..Semper Fi and stay Healthy and your Staff and your Family and be careful of the Virus.

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