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<classification authority="sudocs">GA 1.13:HEHS-98-48</classification>
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 <subject>Health resources utilization</subject>
 <subject>Veterans hospitals</subject>
 <subject>Patient care services</subject>
 <subject>Veterans benefits</subject>
 <subject>Health care cost control</subject>
 <subject>Health care programs</subject>
 <subject>Health services administration</subject>
 <subject>Community health services</subject>
 <identifier>VA Veterans Equitable Resource Allocation System</identifier>
 <identifier>VA Veterans Integrated Service Network</identifier>
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<titleInfo>
 <title>VA Health Care: Status of Efforts to Improve Efficiency and Access</title>
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<abstract>GAO reviewed the Department of Veterans Affairs&apos; (VA) efforts to improve
and monitor veterans&apos; access to health care.&lt;p/&gt;GAO noted that: (1) VA has taken important steps to improve the
efficiency of its health care system and veterans&apos; access to it; (2) VA
medical centers have increased efficiency by expanding the use of
outpatient care; (3) for example, VA has increased the percentage of
surgical procedures performed on an outpatient basis from 34 percent in
fiscal year 1993 to 66 percent by mid-fiscal year 1997; (4) this has
allowed it to reduce bed-days of care, operating beds, and staff; (5) at
the Pittsburgh, Pennsylvania, medical center, the increase in outpatient
surgeries saved more than $7.5 million from October 1995 through May 31,
1997; (6) preventive care, including health assessments and patient
education, has also increased, which VA officials told GAO can lead to
efficiencies because patients can be kept healthier, avoiding expensive
hospital stays; (7) furthermore, VA is increasing efficiency by
integrating services both within and among medical centers; (8) VA is
improving access to health care in several ways; (9) for example, VA has
begun to emphasize primary care, in which generalist physicians see
patients initially and coordinate any specialty care that patients may
need; (10) by increasing the number of primary care teams, VA has
improved access to routine care and expedited referrals to specialty
care; (11) VA is also improving access to health care by providing
outpatient care at additional community-based outpatient clinics,
expanding evening and weekend hours for clinics, and exploring other
innovations; (12) these efforts have shortened the time veterans spend
waiting for an appointment as well as that spent waiting to be seen upon
arrival for an appointment; (13) all of the medical centers GAO visited
have established primary care teams and increased the number of veterans
assigned to primary care; (14) as networks and medical centers continue
to respond to incentives to improve the efficiency of their operations,
headquarters&apos; monitoring of the impact of such responses is necessary to
help ensure that they do not compromise the appropriateness of health
care veterans receive; and (15) GAO found that although VA has
implemented health care monitoring mechanisms to assess some of the
changes networks and medical centers are introducing, these mechanisms
have not fully succeeded.</abstract>
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<note>Letter Report</note>
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<subject>
 <topic>Health resources utilization</topic>
 <topic>Veterans hospitals</topic>
 <topic>Patient care services</topic>
 <topic>Veterans benefits</topic>
 <topic>Health care cost control</topic>
 <topic>Health care programs</topic>
 <topic>Health services administration</topic>
 <topic>Community health services</topic>
 <topic>VA Veterans Equitable Resource Allocation System</topic>
 <topic>VA Veterans Integrated Service Network</topic>
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<relatedItem type="isReferencedBy">
 <titleInfo>
  <title>United States Public Law 262 (104th Congress)</title>
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 <identifier type="public law citation">Public Law 104-262</identifier>
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