Veterans' Health Care

Anecdotal information on veterans' waits for outpatient health care--and the locations and clinics where they wait the longest--has led officials from the Department of Veterans Affairs (VA) and representatives from veteran service organizations to believe that waiting times are often too long. Over the past 10 months, VA has initiated two efforts to gather comprehensive data from its facilities on outpatient waiting time. The first effort, begun in June 1999, produced incomplete and inaccurate data, in part because of the differences in facilities' scheduling of appointments. The second, significantly better effort, begun in December 1999, was designed to improve the data's reliability by measuring the average time taken to schedule an appointment for an entire month; this new method should provide VA with more complete and accurate data. VA has also acted to reduce the time veterans must wait for outpatient appointments. It hired a private contractor to develop and implement techniques to reduce waiting times at selected clinics in VA facilities nationwide and plans to spend $400 million in fiscal year 2001 to improve the timeliness of service, patient access to telephone care, and timely access to clinical information. However, VA's lack of reliable data raises concerns about whether it has an adequate basis on which to design these initiatives. GAO recommends that VA identify the extent and causes of waiting time problems and monitor and track expenditures for addressing them.

GAO noted that: (1) although VA has begun to collect data systematically on waiting times for outpatient care, it has yet to develop reliable national waiting time data; (2) over the past 10 months, VA has initiated two separate efforts for gathering comprehensive outpatient waiting time data from its facilities; (3) the first effort, initiated in June 1999, produced data that were incomplete and inaccurate, in part because of the differences in facilities' scheduling of appointments; (4) VA's second effort, initiated in December 1999, was designed to improve the data's reliability by measuring the average time taken to schedule an appointment for an entire month; (5) VA officials believe that the new method is significantly better and should provide VA with more complete and accurate data; (6) to ensure this, however, VA will need to overcome some problems identified during implementation, such as inaccurate appointment codes being entered into the system; (7) in addition to taking steps to improve its waiting time data, VA has initiated actions to reduce the time veterans must wait for outpatient appointments; (8) VA hired a private contractor to develop and implement techniques to reduce waiting times at selected clinics in VA facilities nationwide; (9) in addition, VA plans to spend $400 million in fiscal year 2001 to make improvements in the timeliness of service, patient access to telephone care, and timely access to clinical information; (10) however, VA's lack of reliable national waiting time data raises concerns about whether VA has an adequate basis upon which to design these initiatives; (11) specifically, without accurate data on the extent of waiting time problems and analyses of the causes of long waits, VA cannot assess whether its proposed expenditures would reduce waiting times or determine how best to allocate funds to reduce waiting times; and (12) without, reliable baseline waiting time data and a mechanism to track the funds used to improve timeliness of care, VA will not be able to objectively measure whether these funds have actually resulted in reduced waiting times.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

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