Measuring approach to health care has traditionally been carried out by the waiting time, that is, how long waiting for the patient to request a promise and to actually see the provider. The Veterans Health Department (VHA) wanted to recognize the limitations of this indicator and better understand how the timely approach to quality medical care looks. Mission 2018. In particular, Article 401 of the law had to develop a measure of the underprivileged in VHA that could evaluate the overall approach in the VAMC (Veterans Affairs Medical Center).
New study
In cooperation with VHA’s integrated veteran care office (officially, Veterans Office), partner’s evidence -based policy resource center (peprec) Each VAMC responded to the order of mission law to measure and alleviate alienation. PEPREC briefly describes this new evidence -based approach. Health service research. In that, PEPREC describes the methodUse the economic principles of supply and demand to identify the marginalized VAMC.
PEPREC defines the alienation as an imbalance between the expected veteran demand for VHA CARE supply and VHA management. In the first year after the law was passed, PEPREC developed a statistical model to measure the alienation of the primary care. (PEPREC has a similar methodology that is ready to implement in special management, but the model has not yet failed.)
Models and variables
This model is centered on new patient waiting times, but takes a step further in consideration of a variety of factors that can affect the waiting time. The relationship between these variables and waiting times is explained by the weight weight assignment. Some increase the waiting time and the other reduces the waiting time. Some have a lot of influence on the waiting time and not many others. The larger weight has more effects on the waiting time.
This model includes 21 variables to comprehensively capture the VHA supply of VHA Care and veteran requirements for VHA management. For example, in terms of supply, PEPREC includes clinic capacity and clinic efficiency, employee measurement and productivity, respectively. In terms of demand, PEPREC includes the average household income in the area surrounding VAMC, the ratio of Veterans with personal insurance, the NOSOS risk score (sickness) and the ratio of Veterans over 65 years old.
Score and facility rankings
This model estimates the relationship between the variables listed above and the primitive waiting time data and creates an alienated score for each VAMC. The higher the VAMC score, the more alienation. In other words, the higher the VAMC’s score, the more difficult to reach the timely treatment for the high -quality treatment for the Veterans.
After running the model and producing the marginalized scores every year, the VAMC is ranked compared to each other.
influence
The marginalized scores of all VAMCs are shared with the integrated veteran care office. There, VAMC with the highest score is informed of the marginalized position. You must submit a plan to explain how to relieve alienation next year. The most inappropriate VAMC and its action plan are shared with Congress through the annual parliamentary report.
Annually THe improves the model and the marginalized score is calculated again.
Importantly, this new approach to measuring approach to treatment can be used in addition to the mission method. Through this model and score, the VHA can systematically identify and solve the imbalance of the supply and demand of VHA treatment through evidence -based policy determination and fair resource allocation. For example, VHA can use the score to guide the mental health clinic operation forecast, budget prediction and local clinic management.
This approach can be used in other health systems and helps both Veterans and non -veterans to access both the required quality control.
It is difficult to understand and manage access to all populations, and the Mission 401 model is just one way to deal with its complexity.
PEPREC is a team of health economists, public health researchers and policy analysts who support VA efforts to improve the lives of Veterans by using advanced quantum methods that are mostly funded by QUERI in the Veterans Health Bureau.
