VA hospitals faulted in funding, care

Post-traumatic stress disorder programs fail to meet goals

September 16, 2007|By McClatchy-Tribune

WASHINGTON -- The Department of Veterans Affairs, which promotes its special programs to treat post-traumatic stress disorder in returning soldiers, spends little on those programs in some parts of the country, and some of its efforts fail to meet some of the VA's own goals, according to internal reports obtained by McClatchy Newspapers.

In fiscal 2006, the reports show, some of the VA's specialized PTSD units spent a fraction of what the average unit did. Five medical centers - in California, Iowa, Louisiana, Tennessee and Wisconsin - spent about $100,000 on their PTSD clinical teams, less than one-fifth the national average.

The documents also show that while the VA's treatment for PTSD is generally effective, nearly a third of the agency's inpatient and other intensive PTSD units failed to meet at least one of the quality goals monitored by a VA health-research organization. The VA medical center in Lexington, Ky., failed to meet four of six quality goals, according to the internal reports.

A top VA mental-health official dismissed the reports' significance, saying veterans receive adequate care, either in specialized PTSD units or from general mental-health providers. In addition, he said, some of the spending differences aren't as extreme as the documents indicate, and the department is working to increase its resources for mental health treatment.

As the VA prepares for a surge of Iraq and Afghanistan veterans experiencing PTSD, it has come under fire for staffing and funding shortfalls in its mental health units and for the wide differences in how much it spends on such treatment at its medical centers.

The agency maintains that it delivers consistently high-quality treatment. "The best measurement of success, and what really counts, is how well we are doing in improving our patients' health," the agency's top medical official, Michael Kussman, said in a statement to McClatchy Newspapers earlier this year. "When we make comparisons among our facilities, our results are uniformly positive."

The spending and quality numbers are in two reports that a VA mental health-research office produces each year. The reports used to be readily available to the public, but the VA removed them from its Web site in the past year. McClatchy obtained the most recent reports, for fiscal 2006, under provisions of the Freedom of Information Act.

One of the reports indicates that the number of veterans using the VA's specialized outpatient PTSD services is growing much faster than the number of medical appointments the VA is providing. The report shows that the number of veterans treated grew more than 4 percent from 2005 to 2006, while the number of appointments the VA provided grew just 1 percent, meaning that the average number of visits each veteran got dropped.

The report also says that the data "suggest considerable variability" across the VA in the delivery of some PTSD services.

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