End‐of‐Life Cost Trajectories in Cancer Patients Treated by Medicare versus the Veterans Health Administration

2020 ◽  
Author(s):  
Risha Gidwani ◽  
Steven M. Asch ◽  
Jack Needleman ◽  
Katherine Faricy‐Anderson ◽  
Derek B. Boothroyd ◽  
...  
Keyword(s):  
End Of Life ◽  
Cancer Patients ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration

scholarly journals End-of-life care for older cancer patients in the Veterans Health Administration versus the private sector

Cancer ◽  
2010 ◽  
Vol 116 (15) ◽  
pp. 3732-3739 ◽  
Author(s):  
Nancy L. Keating ◽  
Mary Beth Landrum ◽  
Elizabeth B. Lamont ◽  
Craig C. Earle ◽  
Samuel R. Bozeman ◽  
...  
Keyword(s):  
Private Sector ◽  
End Of Life ◽  
Cancer Patients ◽  
End Of Life Care ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Life Care ◽  
Health Administration ◽  
Older Cancer Patients

Implementation of gene expression testing for breast cancer patients within the Veterans Health Administration.

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. e17511-e17511
Author(s):  
Julie Ann Lynch ◽  
Brygida Berse ◽  
Kelly Kristin Filipski ◽  
Andrew N Freedman ◽  
Scott DuVall ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Gene Expression ◽  
Cancer Patients ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
Breast Cancer Patients

scholarly journals National Trends in End-of-Life Care for Veterans With Advanced Cancer in the Veterans Health Administration: 2009 to 2016

2019 ◽  
Vol 15 (6) ◽  
pp. e568-e575 ◽  
Author(s):  
Claire E.P. Smith ◽  
Arif H. Kamal ◽  
Monica Kluger ◽  
Patty Coke ◽  
Michael J. Kelley
Keyword(s):  
Lung Cancer ◽  
End Of Life ◽  
Analysis Of Variance ◽  
Stage Iv ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
Icu Admission ◽  
Stage Iv Lung Cancer ◽  
Hospice Use

PURPOSE: It is imperative to provide quality end-of-life (EOL) care for patients with cancer. Although rates of hospice use within the Veterans Health Administration have improved, antineoplastic administration and intensive care unit (ICU) admission at the EOL, indicators of aggressive care, have not clearly declined over recent years. METHODS: We identified 32,665 veterans diagnosed with stage IV lung, colorectal, or pancreatic cancer who died between 2009 and 2016 using a novel EOL Dashboard Tool created from Veterans Administration Cancer Registry data. This EOL tool reports the incidence of antineoplastic drug use in the last 14 days of life, ICU admission in the last 30 days of life, and hospice admission or consult. Change from 2009 to 2016 was assessed using a repeated measures one-way analysis of variance with post hoc test for linear trend of time for individual cancers and two-way analysis of variance for all cancers combined. RESULTS: Antineoplastic use in the last 14 days of life declined from 6.8% in 2009 to 4.4% in 2016 ( P = .03). ICU admission in the last 30 days did not change significantly, from 13.3% in 2009 to 14.7% in 2016. The exception was patients with stage IV lung cancer, in whom ICU admissions increased from 12.9% to 16.2% ( P = .01). Patients using hospice services increased from 32.4% to 52.6% ( P < .01). CONCLUSION: Although antineoplastic administration at the EOL is declining for veterans with stage IV cancer, ICU admissions are unchanged and becoming more common in stage IV lung cancer despite increasing hospice use.

An Intervention With Meaning

Crisis ◽  
2017 ◽  
Vol 38 (6) ◽  
pp. 376-383 ◽  
Author(s):  
Brooke A. Levandowski ◽  
Constance M. Cass ◽  
Stephanie N. Miller ◽  
Janet E. Kemp ◽  
Kenneth R. Conner
Keyword(s):  
High Risk ◽  
Qualitative Methodology ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Safety Planning ◽  
Health Administration ◽  
Suicide Method ◽  
Treatment Providers ◽  
Interactive Nature ◽  
Behavioral Health Treatment

Abstract. Background: The Veterans Health Administration (VHA) health-care system utilizes a multilevel suicide prevention intervention that features the use of standardized safety plans with veterans considered to be at high risk for suicide. Aims: Little is known about clinician perceptions on the value of safety planning with veterans at high risk for suicide. Method: Audio-recorded interviews with 29 VHA behavioral health treatment providers in a southeastern city were transcribed and analyzed using qualitative methodology. Results: Clinical providers consider safety planning feasible, acceptable, and valuable to veterans at high risk for suicide owing to the collaborative and interactive nature of the intervention. Providers identified the types of veterans who easily engaged in safety planning and those who may experience more difficulty with the process. Conclusion: Additional research with VHA providers in other locations and with veteran consumers is needed.

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