Your browser doesn't support javascript.
Excess Mortality Among Patients in the Veterans Affairs Health System Compared With the Overall US Population During the First Year of the COVID-19 Pandemic.
Weinberger, Daniel M; Rose, Liam; Rentsch, Christopher; Asch, Steven M; Columbo, Jesse A; King, Joseph; Korves, Caroline; Lucas, Brian P; Taub, Cynthia; Young-Xu, Yinong; Vashi, Anita; Davies, Louise; Justice, Amy C.
  • Weinberger DM; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut.
  • Rose L; Department of Veterans Affairs Connecticut Healthcare System, West Haven.
  • Rentsch C; Department of Veterans Affairs Medical Center, Palo Alto, California.
  • Asch SM; Surgery Policy Improvement Research and Education Center, Stanford School of Medicine, Palo Alto, California.
  • Columbo JA; Department of Veterans Affairs Connecticut Healthcare System, West Haven.
  • King J; Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom.
  • Korves C; Department of General Internal Medicine, Yale School of Medicine, New Haven, Connecticut.
  • Lucas BP; Department of Veterans Affairs Medical Center, Palo Alto, California.
  • Taub C; Division of Primary Care and Population Health, Stanford School of Medicine, Palo Alto, California.
  • Young-Xu Y; Department of Health Research and Policy, Stanford School of Medicine, Palo Alto, California.
  • Vashi A; Department of Veterans Affairs Medical Center, White River Junction, Vermont.
  • Davies L; Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
  • Justice AC; Department of Veterans Affairs Connecticut Healthcare System, West Haven.
JAMA Netw Open ; 6(5): e2312140, 2023 05 01.
Article in English | MEDLINE | ID: covidwho-2320392
ABSTRACT
Importance During the first year of the COVID-19 pandemic, there was a substantial increase in the rate of death in the United States. It is unclear whether those who had access to comprehensive medical care through the Department of Veterans Affairs (VA) health care system had different death rates compared with the overall US population.

Objective:

To quantify and compare the increase in death rates during the first year of the COVID-19 pandemic between individuals who received comprehensive medical care through the VA health care system and those in the general US population. Design, Setting, and

Participants:

This cohort study compared 10.9 million enrollees in the VA, including 6.8 million active users of VA health care (those with a visit in the last 2 years), with the general population of the US, with deaths occurring from January 1, 2014, to December 31, 2020. Statistical analysis was conducted from May 17, 2021, to March 15, 2023. Main Outcomes and

Measures:

Changes in rates of death from any cause during the COVID-19 pandemic in 2020 compared with previous years. Changes in all-cause death rates by quarter were stratified by age, sex, race and ethnicity, and region, based on individual-level data. Multilevel regression models were fit in a bayesian setting. Standardized rates were used for comparison between populations.

Results:

There were 10.9 million enrollees in the VA health care system and 6.8 million active users. The demographic characteristics of the VA populations were predominantly male (>85% in the VA health care system vs 49% in the general US population), older (mean [SD], 61.0 [18.2] years in the VA health care system vs 39.0 [23.1] years in the US population), and had a larger proportion of patients who were White (73% in the VA health care system vs 61% in the US population) or Black (17% in the VA health care system vs 13% in the US population). Increases in death rates were apparent across all of the adult age groups (≥25 years) in both the VA populations and the general US population. Across all of 2020, the relative increase in death rates compared with expected values was similar for VA enrollees (risk ratio [RR], 1.20 [95% CI, 1.14-1.29]), VA active users (RR, 1.19 [95% CI, 1.14-1.26]), and the general US population (RR, 1.20 [95% CI, 1.17-1.22]). Because the prepandemic standardized mortality rates were higher in the VA populations prior to the pandemic, the absolute rates of excess mortality were higher in the VA populations. Conclusions and Relevance In this cohort study, a comparison of excess deaths between populations suggests that active users of the VA health system had similar relative increases in mortality compared with the general US population during the first 10 months of the COVID-19 pandemic.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Veterans / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Female / Humans / Male Country/Region as subject: North America Language: English Journal: JAMA Netw Open Year: 2023 Document Type: Article

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Veterans / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Female / Humans / Male Country/Region as subject: North America Language: English Journal: JAMA Netw Open Year: 2023 Document Type: Article