Veterans Health Administration

David L. Evers, Armed Forces Institute of Pathology, Rockville, MD, and Veterans Health Administration, Washington, DC... 

The Department of Veterans Affairs provides treatment services for veterans. The budget for this was over 402 million in 2004, 386 million in 2005, and is 401 million in 2006. No PART review has been conducted, nor has the Veterans Health Administration established outcome measures. The agency did set a target that 32 percent of the veterans served would receive appropriate care. In 2004, they determined that 28 percent had actually received appropriate care. 

Stalhandske E, DeRosier J, Wilson R, Murphy J. Healthcare FMEA in the veterans health administration. Patient safety and quality healthcare. 2009. 

Carney, B.T., West, R, Neily, J., Mills, P.D. and Bagian, J.P. 2011. Changing perceptions of safety climate in the operating room with the Veterans Health Administration medical team training program. American Journal of Medical Quality, 26, 181M. 

Heget, J. R., Bagian, J. E, Lee, C. Z., and Gosbee, J. W. System Innovation Veterans Health Administration National Center for Patient Safety. Joint Commission Journal of Quality Improvement, 2002, 25(12), 660-665. 

Emergency Management Principles and Practices for Healthcare Systems. Washington, DC The Institute for Crisis, Disaster, and Risk Management (ICDRM) at the George Washington University (GWU) for the Veterans Health Administration (VHA)/US Department of Veterans Affairs (VA). June 2006. 

Mezuk B, Morden NE, Ganoczy D, Post EP, Kilbourne AM. Anticonvulsant use, bipolar disorder, and risk of fracture among older adults in the Veterans Health Administration. Am J Geriatr Psychiatry 2010 18(3) 245-55. 

French DD, Margo CE. Postmarketing surveillance of corneal edema, Fuchs dystrophy, and amantadine use in the Veterans Health Administration. Cornea 2007 26 1087-9. 

The FDA warning on citalopram remains controversial. A retrospective cohort study [34 ], using Veterans Health Administration data collected between 2004 and 2009 from depressed patients who either received a prescription for citalopram (n=6,18,450) or a comparison medication, sertraline (n=3,65,898), found citalopram daily doses of above 40 mg were not associated with a higher risk of ventricular arrhythmia, or cardiac or noncardiac death. In fact, the authors found that citalopram dosages above 40 mg per day were associated with a statistically significantly reduced risk of ventricular arrhythmia, all-cause mortality and noncardiac mortality compared to doses of 20 mg or less. 

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