Seminar - Comparing Geriatrics Primary Care to Usual Primary Care in the VA System

Wednesday, May 10, 2023

Join our HPM Department for this in-person seminar by Courtney Van Houtven, PhD, from Duke's Margolis Center for Health Policy

WEDNESDAY, MAY 10, 11:45AM-12:45PM

Rosenfield Building, 722 West 168th Street, Room 440

Quality of Care in Geriatrics Primary Care Compared to Usual Primary Care in the Veterans Affairs Health Care System: a National Comparative Effectiveness Study

Geriatric Patient Aligned Care Teams (GeriPACTs) combine primary care with specialty expertise for older Veterans in order to promote independence and quality of life. GeriPACT effectiveness is vital to guide Veterans Affairs scaling decisions. Our objective was to examine how quality of care (QOC) measures change when a patient moves from usual primary care (PACT) to GeriPACT. We designed a prospective survey study to assess perceived quality of care measures along with electronic health record (EHR) quality measures. We used matching in this prospective cohort study to enroll similar GeriPACT-PACT dyads and minimize endogeneity bias. QOC measures from EHR data were rates of completed advance directives, falls screening, incontinence screening, and functional assessment within 18 months of the first GeriPACT or PACT visit during the exposure period. QOC measures from survey data were two 20-point scales from the patient perceptions of integrated care measure at 18 months (Support for Self-Directed Care and Support for Medication and Home Health Management Scales). We find that older Veterans who transitioned to a specialized geriatrics primary care clinic experienced improved QOC as assessed in EHR measures and marginally significant improvements in patient perceptions of integrated care.  Findings indicate that further investment in GeriPACTs can be expected to improve multiple aspects of quality of care for older adults enrolled in the VA Health Care System.


Courtney Van Houtven