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Regional variations in health status.
D H Au1, M B McDonell, D C Martin
1Northwest Health Services Research and Development Center of Excellence, VA Puget Sound Health Care System, Seattle, Washington, USA. dau@u.washington.edu
Medical Care
|July 27, 2001
Summary
Patient health status and chronic conditions vary significantly across different primary care clinics within the Department of Veterans Affairs (VA) healthcare system. Sociodemographic and comorbid factors largely explain these observed health variations.
Area of Science:
- Health Services Research
- Public Health
- Clinical Epidemiology
Background:
- Limited understanding of health status variations in US primary care patients.
- Need to investigate regional differences in patient health within integrated healthcare systems.
Purpose of the Study:
- Examine regional variations in physical and mental health.
- Assess patients receiving primary care in the Department of Veterans Affairs (VA) system.
Main Methods:
- Cross-sectional survey of 54,844 patients across seven VA clinics.
- Mailed questionnaires assessing health status and chronic conditions.
- Analysis of 30,690 returned questionnaires.
Main Results:
- Prevalence of chronic conditions varied up to 60% among clinics.
- General health (SF-36) also varied significantly, mirroring condition prevalence.
- Geographic site explained a small variance in health status after adjustments.
Conclusions:
- Substantial health differences exist among VA primary care clinics.
- Implications for evaluating clinical performance and health outcomes.
- Sociodemographic and comorbid factors are primary drivers of these differences.