Cost of Veteran Coronary Artery Bypass Grafting: Veterans Health Administration Versus Community Care

IF 1.7 3区医学 Q2 SURGERY

Journal of Surgical Research Pub Date : 2025-10-01 DOI:10.1016/j.jss.2025.09.001

Jake L. Cotton MD , Adnan Syed BS , Danielle Abbitt MD , Andrew Mecum BA , Chiagoziem Anigbogu BA , Teresa S. Jones MD , Muhammad Aftab MD , Jessica Y. Rove MD , Edward L. Jones MD

{"title":"Cost of Veteran Coronary Artery Bypass Grafting: Veterans Health Administration Versus Community Care","authors":"Jake L. Cotton MD , Adnan Syed BS , Danielle Abbitt MD , Andrew Mecum BA , Chiagoziem Anigbogu BA , Teresa S. Jones MD , Muhammad Aftab MD , Jessica Y. Rove MD , Edward L. Jones MD","doi":"10.1016/j.jss.2025.09.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>The community care program within the Veterans Health Administration (VHA) funds veteran care in the community. Cost of this program has increased with limited comparisons between VHA and community care hospitals. We seek to compare differences in cost of coronary artery bypass grafting (CABG) between VHA and community care hospitals.</div></div><div><h3>Methods</h3><div>We perform a retrospective cohort review of veterans undergoing CABG between October 1, 2018, and September 30, 2020, within VHA and community care hospitals within Veteran Integrated Service Network 19. Cost of index hospitalization was measured using VHA databases.</div></div><div><h3>Results</h3><div>Three hundred sixty-one veterans met final inclusion criteria at a total of 37 hospitals. One hundred ninety-five (54%) underwent surgery within the VHA and 166 (46%) underwent surgery in the community. CABG performed within the VHA were similar in cost to community (VHA median [interquartile range]: $122,213 [$80,829-$162,586] <em>versus</em> community: $112,923 [$74,797-$154,729]; <em>P</em> = 0.23), despite a longer postoperative length of stay. When controlling for other factors including hospital length of stay with a log gamma model, VHA performed CABG were less expensive than community (<em>P</em> = 0.007). There was no difference in index hospitalization metrics and 30-d outcomes.</div></div><div><h3>Conclusions</h3><div>CABG within the VHA is lower cost than community care after controlling for other factors. Continuous evaluation of community care cost is necessary to ensure efficient use of funding and program sustainability.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"315 ","pages":"Pages 145-150"},"PeriodicalIF":1.7000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Surgical Research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0022480425005505","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction

The community care program within the Veterans Health Administration (VHA) funds veteran care in the community. Cost of this program has increased with limited comparisons between VHA and community care hospitals. We seek to compare differences in cost of coronary artery bypass grafting (CABG) between VHA and community care hospitals.

Methods

We perform a retrospective cohort review of veterans undergoing CABG between October 1, 2018, and September 30, 2020, within VHA and community care hospitals within Veteran Integrated Service Network 19. Cost of index hospitalization was measured using VHA databases.

Results

Three hundred sixty-one veterans met final inclusion criteria at a total of 37 hospitals. One hundred ninety-five (54%) underwent surgery within the VHA and 166 (46%) underwent surgery in the community. CABG performed within the VHA were similar in cost to community (VHA median [interquartile range]: $122,213 [$80,829-$162,586] versus community: $112,923 [$74,797-$154,729]; P = 0.23), despite a longer postoperative length of stay. When controlling for other factors including hospital length of stay with a log gamma model, VHA performed CABG were less expensive than community (P = 0.007). There was no difference in index hospitalization metrics and 30-d outcomes.

Conclusions

CABG within the VHA is lower cost than community care after controlling for other factors. Continuous evaluation of community care cost is necessary to ensure efficient use of funding and program sustainability.

查看原文本刊更多论文

退伍军人冠状动脉搭桥术的费用：退伍军人健康管理与社区护理。

简介：退伍军人健康管理局（VHA）的社区护理计划为社区的退伍军人护理提供资金。在VHA和社区护理医院之间的有限比较中，该计划的成本增加了。我们试图比较VHA和社区护理医院之间冠状动脉旁路移植术（CABG）成本的差异。方法：我们对2018年10月1日至2020年9月30日期间在VHA和退伍军人综合服务网络19内的社区护理医院接受CABG的退伍军人进行回顾性队列研究。使用VHA数据库测量指数住院费用。结果：37家医院共361名退伍军人符合最终纳入标准。195人（54%）在VHA内接受手术，166人（46%）在社区接受手术。在VHA内进行CABG的费用与社区相似（VHA中位数[四分位数范围]:122,213美元[80,829美元- 162,586美元]与社区：112,923美元[74,797美元- 154,729美元]；P = 0.23），尽管术后住院时间更长。当用log - gamma模型控制包括住院时间在内的其他因素时，VHA实施CABG的费用低于社区（P = 0.007）。两组住院指标和30 d结局无差异。结论：在控制其他因素后，VHA内CABG的成本低于社区护理。为了确保资金的有效使用和项目的可持续性，对社区护理成本进行持续评估是必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Surgical Research 医学-外科

CiteScore

3.90

自引率

4.50%

发文量

627

审稿时长

138 days

期刊介绍： The Journal of Surgical Research: Clinical and Laboratory Investigation publishes original articles concerned with clinical and laboratory investigations relevant to surgical practice and teaching. The journal emphasizes reports of clinical investigations or fundamental research bearing directly on surgical management that will be of general interest to a broad range of surgeons and surgical researchers. The articles presented need not have been the products of surgeons or of surgical laboratories. The Journal of Surgical Research also features review articles and special articles relating to educational, research, or social issues of interest to the academic surgical community.