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Study design and sampling in the Veterans Health Study.

Donald R Miller¹, Katherine M Skinner, Lewis E Kazis

¹Center for Health Quality, Outcomes, and Economic Research (CHQOER), Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Mass 01730, USA. drmiller@bu.edu

The Journal of Ambulatory Care Management

|April 9, 2004

Summary

The Veterans Health Study (VHS) used a longitudinal observational design to assess healthcare's impact on patient outcomes within the Veterans Health Administration. This comprehensive approach provides a model for future patient-reported outcomes research.

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Area of Science:

Health Services Research
Patient-Reported Outcomes
Longitudinal Study Design

Background:

Designing studies on healthcare's impact on patient-reported outcomes involves critical choices.
The Veterans Health Administration (VA) system presents unique opportunities and challenges for such research.

Purpose of the Study:

To describe the design considerations for the Veterans Health Study (VHS).
To examine the impact of healthcare on patient-reported outcomes within the VA.
To discuss sampling, theoretical, and practical implications of the VHS design.

Main Methods:

A prospective, longitudinal observational study design.
Recruitment from a cross-sectional sample of VA patients visiting ambulatory care clinics.
Data collection via telephone interviews, mailed questionnaires, and in-person clinic assessments at baseline, 3-month intervals, and 12/24-month reassessments.

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Main Results:

The comprehensive, observational design allowed examination of routine VA healthcare processes and outcomes.
The longitudinal approach enabled tracking changes in health status and linking them to illnesses and treatments.
The study design minimized potential study effects on patient outcomes.

Conclusions:

The VHS design offers a robust model for future studies on healthcare effects on patient-reported outcomes.
Careful consideration of design choices and lessons learned from prior research were incorporated.
The study's strengths lie in its comprehensiveness, observational nature, and longitudinal follow-up within a real-world healthcare system.