Veterans Health Administration Delivers Quality Care to Older Men with Cancer

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(ChemotherapyAdvisor) – Older men with cancer treated in Veterans Health Administration (VHA) hospitals had a survival rate better than or equivalent to similar fee-for-service Medicare beneficiaries, results of a study in the Journal of Clinical Oncology published online March 5 have found.

To date, few studies have documented improved patient outcomes resulting from VHA care. The investigators compared survival rates of older patients with cancer in the VHA to fee-for-service Medicare. Stage at diagnosis, receipt of guideline-recommended therapies, and unmeasured characteristics were examined to determine survival differences.

All-cause and cancer-specific survival rates for men >65 years of age who were diagnosed or received their first course of treatment for colorectal, lung, lymphoma, or multiple myeloma in VHA hospitals from 2001 to 2004 were compared to similar fee-for-service Medicare enrollees diagnosed within the same time frame in Surveillance, Epidemiology, and End Results (SEER) areas. Median follow-up was three years.

Patients treated in VHA hospitals had higher survival rates of colon cancer (HR, 0.87) and non–small-cell lung cancer (NSCLC, HR, 0.91) than fee-for-service SEER-Medicare patients, while similar survival rates were observed between the two groups for rectal cancer (HR, 1.05), small-cell lung cancer (HR, 0.99), diffuse large–B-cell lymphoma (HR, 1.02), and multiple myeloma (HR, 0.92).

Much of the survival advantage for colon cancer and NSCLC for VHA patients was attributed to diagnosis at earlier stages and with smaller tumors than the fee-for-service Medicare patients. “Because these findings may reflect the positive effects of an integrated, coordinated system of care on outcomes for a complex patient population, the VHA system might serve as a model for care delivery as healthcare reform is implemented,” the investigators wrote.


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