Assessing the impact of prescribing directives on opioid prescribing practices among Veterans Health Administration providers

2016 ◽  
Vol 26 (1) ◽  
pp. 40-46 ◽  
Author(s):  
Catherine Barber ◽  
David Gagnon ◽  
Jennifer Fonda ◽  
Kelly Cho ◽  
John Hermos ◽  
...  
Keyword(s):  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
Prescribing Practices ◽  
Opioid Prescribing ◽  
The Impact

Palliative Radiotherapy Within the Veterans Health Administration: Barriers to Referral and Timeliness of Treatment

2021 ◽  
pp. OP.20.00981
Author(s):  
Ruchika Gutt ◽  
Sheetal Malhotra ◽  
Michael P. Hagan ◽  
Steve P. Lee ◽  
Katherine Faricy-Anderson ◽  
...  
Keyword(s):  
Palliative Radiotherapy ◽  
Veterans Health Administration ◽  
Cord Compression ◽  
Veterans Health ◽  
Radiation Oncologist ◽  
Health Administration ◽  
Chi Square ◽  
Palliative Radiation Therapy ◽  
Chi Square Analysis ◽  
The Impact

PURPOSE: Most Veterans Health Administration hospitals do not have radiation oncology (RO) departments on-site. The purpose of this study is to determine the impact of on-site RO on referral patterns and timeliness of palliative radiation therapy (PRT). MATERIALS AND METHODS: A survey was sent to medical directors at 149 Veterans Health Administration centers. Questions evaluated frequency of referral for PRT, timeliness of RO consults and treatment, and barriers to referral for PRT. Chi-square analysis was used to evaluate differences between centers that have on-site RO and centers that refer to outside facilities. RESULTS: Of 108 respondents, 33 (31%) have on-site RO. Chi-square analysis revealed that RO consult within 1 week is more likely at centers with on-site RO (68% v 31%; P = .01). Centers with on-site RO more frequently deliver PRT for spinal cord compression within 24 hours (94% v 70%; P = .01). Those without on-site RO were more likely to want increased radiation oncologist involvement (64% v 26%; P < .001). Barriers to referral for PRT included patient ability to travel (81%), patient noncompliance (31%), delays in consult and/or treatment (31%), difficulty contacting a radiation oncologist (14%), and concern regarding excessive number of treatments (13%). Respondents with on-site RO less frequently reported delays in consult and/or treatment (6% v 41%; P < .0001) and difficulty contacting a radiation oncologist (0% v 20%; P = .0056) as barriers. CONCLUSION: Respondents with on-site RO reported improved communication with radiation oncologists and more timely consultation and treatment initiation. Methods to improve timeliness of PRT for veterans at centers without on-site RO should be considered.

scholarly journals High Variability of Opioid Prescribing Within and Across Emergency Departments in the US Veterans Health Administration

2018 ◽  
Vol 33 (11) ◽  
pp. 1831-1832
Author(s):  
Timothy Joseph Sowicz ◽  
Adam J. Gordon ◽  
Walid F. Gellad ◽  
Xinhua Zhao ◽  
Hongwei Zhang ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Veterans Health Administration ◽  
High Variability ◽  
Veterans Health ◽  
Health Administration ◽  
Opioid Prescribing ◽  
The Us ◽  
Us Veterans

scholarly journals Opioid Prescribing and Opioid Risk Mitigation Strategies in the Veterans Health Administration

2020 ◽  
Vol 35 (S3) ◽  
pp. 927-934
Author(s):  
Friedhelm Sandbrink ◽  
Elizabeth M. Oliva ◽  
Tara L. McMullen ◽  
Amy R. Aylor ◽  
Michael A. Harvey ◽  
...  
Keyword(s):  
Risk Mitigation ◽  
Veterans Health Administration ◽  
Mitigation Strategies ◽  
Veterans Health ◽  
Health Administration ◽  
Opioid Prescribing ◽  
Risk Mitigation Strategies

scholarly journals Inpatient antibiotic utilization in the Veterans’ Health Administration during the coronavirus disease 2019 (COVID-19) pandemic

2020 ◽  
pp. 1-3 ◽  
Author(s):  
Thomas D. Dieringer ◽  
Daisuke Furukawa ◽  
Christopher J. Graber ◽  
Vanessa W. Stevens ◽  
Makoto M. Jones ◽  
...  
Keyword(s):  
Antibiotic Use ◽  
Veterans Health Administration ◽  
Antibiotic Prescribing ◽  
Veterans Health ◽  
Health Administration ◽  
Prescribing Practices ◽  
Antibiotic Utilization ◽  
Days Of Therapy

Abstract Antibiotic prescribing practices across the Veterans’ Health Administration (VA) experienced significant shifts during the coronavirus disease 2019 (COVID-19) pandemic. From 2015 to 2019, antibiotic use between January and May decreased from 638 to 602 days of therapy (DOT) per 1,000 days present (DP), while the corresponding months in 2020 saw antibiotic utilization rise to 628 DOT per 1,000 DP.

scholarly journals The Veterans Health Administration: A Preliminary Analysis of the Influence of The Independent Budget and Bureaucratic Performance on Funding Trends

2008 ◽  
Vol 15 (1) ◽  
pp. 5
Author(s):  
Elizabeth Kidder
Keyword(s):  
Veterans Health Administration ◽  
Service Organizations ◽  
The Political ◽  
Veterans Health ◽  
Health Administration ◽  
The Past ◽  
Bureaucratic Performance ◽  
The Cost ◽  
The Impact

The Veterans Health Administration (VHA) is the largest integrated health system in the U.S. with 7.9 million U.S. veterans enrolled.  Both the number of veterans seeking VHA health services and the cost of delivering such services continue to rise as a result of myriad factors. Kidder examines VHA funding outcomes over the past 10 years in light of the participation of veterans' service organizations (VSOs) in committee hearings; the reliance of lawmakers upon The Independent Budget (IB); and the impact of new performance-based management initiatives on budget outcomes.  Her article highlights the political nature of the VHA budget and the influential role of VSOs in funding outcomes.

scholarly journals Regional and Rural–Urban Variation in Opioid Prescribing in the Veterans Health Administration

2019 ◽  
Vol 184 (11-12) ◽  
pp. 894-900 ◽  
Author(s):  
Brian C Lund ◽  
Michael E Ohl ◽  
Katherine Hadlandsmyth ◽  
Hilary J Mosher
Keyword(s):  
Rural Areas ◽  
Regional Variation ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
Opioid Use ◽  
Opioid Prescribing ◽  
Rural And Urban ◽  
Per Capita

Abstract Introduction Opioid prescribing is heterogenous across the US, where 3- to 5-fold variation has been observed across states or other geographical units. Residents of rural areas appear to be at greater risk for opioid misuse, mortality, and high-risk prescribing. The Veterans Health Administration (VHA) provides a unique setting for examining regional and rural–urban differences in opioid prescribing, as a complement and contrast to extant literature. The objective of this study was to characterize regional variation in opioid prescribing across Veterans Health Administration (VHA) and examine differences between rural and urban veterans. Materials and Methods Following IRB approval, this retrospective observational study used national administrative VHA data from 2016 to assess regional variation and rural–urban differences in schedule II opioid prescribing. The primary measure of opioid prescribing volume was morphine milligram equivalents (MME) dispensed per capita. Secondary measures included incidence, prevalence of any use, and prevalence of long-term use. Results Among 4,928,195 patients, national VHA per capita opioid utilization in 2016 was 1,038 MME. Utilization was lowest in the Northeast (894 MME), highest in the West (1,368 MME), and higher among rural (1,306 MME) than urban (988 MME) residents (p &lt; 0.001). Most of the difference between rural and urban veterans (318 MME) was attributable to differences in long-term opioid use (312 MME), with similar rates of short-term use. Conclusion There is substantial regional and rural–urban variation in opioid prescribing in VHA. Rural veterans receive over 30% more opioids than their urban counterparts. Further research is needed to identify and address underlying causes of these differences, which could include access barriers for non-pharmacologic treatments for chronic pain.

scholarly journals Emergency Physician Opioid Prescribing and Risk of Long-term Use in the Veterans Health Administration: an Observational Analysis

2019 ◽  
Vol 34 (8) ◽  
pp. 1522-1529 ◽  
Author(s):  
Michael L. Barnett ◽  
Xinhua Zhao ◽  
Michael J. Fine ◽  
Carolyn T. Thorpe ◽  
Florentina E. Sileanu ◽  
...  
Keyword(s):  
Emergency Physician ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
Observational Analysis ◽  
Opioid Prescribing

scholarly journals The Impact of Hospital Operative Volume on Esophagectomy Outcomes in the Veterans Health Administration: a Propensity Score Matched Analysis

2021 ◽  
Vol 233 (5) ◽  
pp. S265
Author(s):  
Timothy J. Holleran ◽  
Michael A. Napolitano ◽  
Andrew D. Sparks ◽  
Jared L. Antevil ◽  
Fredrick J. Brody ◽  
...  
Keyword(s):  
Propensity Score ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
The Impact

scholarly journals The Impact of the 2004–2005 Influenza Vaccine Shortage in the Veterans Health Administration

2007 ◽  
Vol 22 (8) ◽  
pp. 1132-1138 ◽  
Author(s):  
Leila C. Kahwati ◽  
John R. Elter ◽  
Kristy A. Straits-Tröster ◽  
Linda S. Kinsinger ◽  
Victoria J. Davey
Keyword(s):  
Influenza Vaccine ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
The Impact ◽  
Vaccine Shortage

Examining the Impact of the AHRQ Patient Safety Indicators (PSIs) on the Veterans Health Administration

Medical Care ◽  
2013 ◽  
Vol 51 (1) ◽  
pp. 37-44 ◽  
Author(s):  
Amy K. Rosen ◽  
Susan Loveland ◽  
Marlena Shin ◽  
Michael Shwartz ◽  
Amresh Hanchate ◽  
...  
Keyword(s):  
Patient Safety ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
Patient Safety Indicators ◽  
The Impact
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