ArticleHealth services research2020
Comparing cataract surgery complication rates in veterans receiving VA and community care.
Article in Health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 27 citations in OpenAlex.
- Payment Source Shift for Surgical Care Among Veterans Enrolled in Medicare Advantage Plans.JAMA health forum · 2025Article
- Comparing Quality, Costs, and Outcomes of VA and Community Primary Care for Patients with Diabetes.Journal of general internal medicine · 2025Article
- Strabismus and Strabismus Surgery in the U.S. Veterans Health Administration: Foundational Analyses of Electronic Health Record Data from 2000 to 2022.Journal of personalized medicine · 2025Article
- Quality improvement lessons learned from National Implementation of the "Patient Safety Events in Community Care: Reporting, Investigation, and Improvement Guidebook".Health services research · 2024Article
- Trends in Bundled Outpatient Behavioral Health Services in VA-Direct Versus VA-Purchased Care.Administration and policy in mental health · 2024Article
- Determinants of referral network size for screening colonoscopies in the Veterans Health Administration after the implementation of the MISSION Act.Health services research · 2024Article
- Location and Types of Treatment for Prostate Cancer After the Veterans Choice Program Implementation.JAMA network open · 2023Article
- The Promise and Challenges of VA Community Care: Veterans' Issues in Focus.Rand health quarterly · 2023Article
- What is the role of selection bias in quality comparisons between the Veterans Health Administration and community care? Example of elective hernia surgery.Health services research · 2023Article
- Using RE-AIM to examine implementation of a tele-nephrology program for veterans living in rural areas.Frontiers in health services · 2023Article
- Data Sources for Evaluating Health Disparities in Ophthalmology: Where We Are and Where We Need to Go.Ophthalmology · 2022Article
- Association of Quality of Care With Where Veterans Choose to Get Knee Replacement Surgery.JAMA network open · 2022Article
- Comparing Postoperative Readmission Rates Between Veterans Receiving Total Knee Arthroplasty in the Veterans Health Administration Versus Community Care.Medical care · 2022Observational
- Comparing Complication Rates After Elective Total Knee Arthroplasty Delivered Or Purchased By The VA.Health affairs (Project Hope) · 2021Article
- Comparing cataract surgery complication rates in veterans receiving VA and community care.Health services research · 2020Article
- Estimating the Cost of Surgical Care Purchased in the Community by the Veterans Health Administration.MDM policy & practiceArticle
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
Abstract
objectivesTo compare 90-day postoperative complication rates between Veterans receiving cataract surgery in VA vs Community Care (CC) during the first year of implementation of the Veterans Choice Act. DATA SOURCES: Fiscal Year (FY) 2015 VA and CC outpatient data from VA's Corporate Data Warehouse (CDW) 10/01/14-9/30/15). FY14 data were used to obtain baseline clinical information prior to surgery. STUDY
designRetrospective one-year study using secondary data to compare 90-day complication rates following cataract surgery (measured using National Quality Forum (NQF) criteria) in VA vs CC. NQF defines major complications from a specified list of Current Procedural Terminology (CPT) codes. We ran a series of logistic regression models to predict 90-day complication rates, adjusting for Veterans' sociodemographic characteristics, comorbidities, preoperative ocular conditions, eye risk group, and type of cataract surgery (classified as routine vs complex). DATA COLLECTION: We linked VA and CC users through patient identifiers obtained from the CDW files. Our sample included all enrolled Veterans who received outpatient cataract surgery either in the VA or through CC during FY15. Cataract surgeries were identified through CPT codes 66 984 (routine) and 66 982 (complex). PRINCIPAL
findingsOf the 83,879 cataract surgeries performed in FY15, 31 percent occurred through CC. Undergoing complex surgery and having a high-risk eye (based on preoperative ocular conditions) were the strongest clinical predictors of 90-day postoperative complications. Overall, we found low complication rates, ranging from 1.1 percent in low-risk eyes to 3.6 percent in high-risk eyes. After adjustment for important confounders (eg, race, rurality, and preoperative ocular conditions), there were no statistically significant differences in 90-day complication rates between Veterans receiving cataract surgery in VA vs CC.
conclusionsAs more Veterans seek care through CC, future studies should continue to monitor quality of care across the two care settings to help inform VA's "make vs buy decisions."
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Registered trials
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