NEW RELEASE DATE ANNOUNCED
This material, originally scheduled for an April 6 release, has been updated to integrate the most recently released data for February from the U.S. Department of Veterans Affairs.
Public release of the data and any related stories are embargoed until Thursday, April 9. The updated material can now be downloaded using the link below.
About the dataset
In response to concerns about long waits for care at some of its hospitals, the U.S. Department of Veterans Affairs began releasing statistics last May on the timeliness of medical appointments at about 1,000 facilities in its health care system. In August, Congress gave the VA an additional $16.3 billion to attack the problem by hiring by more doctors, opening new clinics, and expanding a program that is supposed to make it easier for vets to get care outside the VA system if they can't get a timely appointment. The Associated Press is examining the latest data to see whether wait times have started to improve as a result of the funding injection and other reforms. The AP also is exploring what the VA is doing to address delays at the facilities where waits are worst.
The AP originally made this data available covering a time period that ended in January. It has now been updated to include statistics for February.
The AP is providing three spreadsheets that offer opportunities for members and customers to localize the data for their audiences. One spreadsheet shows how each of 940 VA hospitals and outpatient clinics performed on wait times from Sept. 1, 2014, to Feb. 28, 2015. Three ranges for the length of delays are provided for each facility. The second spreadsheet provides the same data month by month. The third contains national totals covering the period Aug. 1, 2014 to Feb. 28, 2015. The VA tracks several types of statistics related to wait times, but for this analysis, the AP chose to highlight appointments that failed to meet the VA's timeliness standard, which calls for patients to wait no longer than 30 days for non-emergency care. The VA is the source for all three sets.
- va_completed_appointments_totals.xlsx - This spreadsheet shows the total number of appointments that were completed at each VA hospital and outpatient clinic between Sept. 1, 2014 and Feb. 28, 2015, and the percentage of those appointments that involved a delay of at least 31 days. It also shows the number of appointments delayed 31-60 days, 61-90 days or more than 90 days. CORRECTION: The original spreadsheet included in this package misidentified the Macon VA Clinic of Macon, GA, as the Elko Outreach Clinic of Elko, NV. This error also created a duplicate entry for the Elko Outreach Clinic.The spreadsheet linked below correctly identifies the Macon clinic while retaining the entry for the actual Elko Outreach Clinic.
- va_completed_appointments_monthly.xlsx - This spreadsheet charts how the timeliness statistics changed from month to month. It includes monthly totals of the number of appointments completed at each facility and the percentage of those appointments each month where care was delayed by more than 30 days. CORRECTION: The original spreadsheet included in this package misidentified the Macon VA Clinic of Macon, GA, as the Elko Outreach Clinic of Elko, NV. This error also created a duplicate entry for the Elko Outreach Clinic.The spreadsheet linked below correctly identifies the Macon clinic while retaining the entry for the actual Elko Outreach Clinic.
- va_completed_appointments_national.xlsx - This chart shows a monthly breakdown of the number of appointments handled nationally by the VA health system between Aug. 1, 2014 and Feb. 28, 2015, and the percentage of those appointments that were delayed.
The monthly and totals spreadsheets contain the location and type of each facility. The types are as follows:
- CBOC - Community Based Outpatient Clinic
- VAMC - Veterans Affairs Medical Center
- IOC - Independent Outpatient Clinic
- MOC - Mobile Outpatient Clinic
An AP national story will be slugged "Veterans-Health Care". Information in the IMPORTANT NOTES and BACKGROUND sections of the README file is publishable in localized stories.
DOWNLOAD THE DATA
Below figures are derived from monthly totals of completed appointments, nationally, for August through February.
|Completed Appointments||Care delayed at least 31 days||Pct delayed at least 31 days||Care delayed 31-60 days||Pct delayed 31-60 days||Care delayed 61-90 days||Pct delayed 61-90 days||Care delayed more than 90 days||Pct delayed more than 90 days|
IMPORTANT NOTES about the dataset
- While the VA has made wait-time data available for as many as 1,017 facilities in some months, this dataset includes detailed wait times for 940 hospitals and outpatient clinics. It excludes homeless dormitories, residential rehabilitation centers and Integrated Disability Evaluation System offices. It also excludes a few small VA clinics where data was available for some months, but not others. The spreadsheet containing national totals for the system, however, includes all VA sites.
- Late last summer, the VA introduced a new methodology for calculating delays. The new system measures waits based on something called the "preferred date," which is either the day the vet wishes to be seen or a day determined to be medically necessary by their care provider. Delays are calculated by measuring the time that elapses between the preferred date and the date when the patient can get an appointment. Previously, waits for new patients had been calculated based on when a clerk created the appointment in the scheduling system, not when the patient actually needed or wanted to be seen by the doctor. VA officials say the new method gives a more accurate picture of delays, but its adoption also meant that around half of all patient appointments previously logged as being "delayed" are now being classified as meeting VA timeliness standards. This prevents an easy comparison between the statistics the VA released in May, June and July with data that subsequently became available on the national level in August and at the facility level since September. The dataset being provided here includes only appointments completed from September onward, when the new methodology was in place.
- In the fall, the VA also stopped releasing statistics showing the difference in wait times between new patients and established ones.
- This dataset focuses only on appointments that have been successfully completed. It does not include patient no-shows or appointments that were made, but were subsequently cancelled.
- The VA separately releases data on "pending appointments," which are patient visits that have been scheduled, but have yet to take place. That data, while potentially useful, is not included here. Among the reasons: Statistics on pending appointments exclude instances where the patient can be seen immediately. They also include a large number of appointments that are subsequently changed, cancelled, or not kept by the patient. More appointments are scheduled than actually take place.
- The VA separately publishes data on average wait times for certain types of care. Those averages are not included in this dataset. While average wait times can be a useful tool, they can also disguise problems. For example, a facility with an unacceptable number of patients waiting two or three months for care might still have a low average wait time in the categories tracked by the VA if they see most patients in that category promptly.
- This dataset does not include instances where a VA patient receives treatment at a non-VA facility.
- The VA's completed appointment data does not include appointments for surgical procedures.
The VA began auditing and reporting wait times last spring after a scandal over attempts at many facilities to cover up delays by manipulating the medical network's scheduling system.
Attempts to game the statistics included tricks like keeping unofficial lists of patients who needed to be scheduled for an appointment, so that the full time they spent waiting to see a medical provider wouldn't be documented. It is unclear how effective the VA has been at halting those practices, but it claims to have made great strides.
The problem of long waits and falsified statistics was well known within the VA, and had been the subject of numerous reports by government oversight agencies over the years, but public attention reached such a peak last May that it led to the resignation of VA Eric Shinseki.
President Barack Obama signed the Veterans Access, Choice and Accountability Act in August. It made $16.3 billion available to reduce wait times. A hallmark of the legislation was the VA's new "Choice," program, which was intended to ease wait times by giving more vets the option of getting care outside the system.
Vets began getting the ID cards they need to use the program in November, but so far it has gotten only light use. Between Nov. 5 and March 17, according to VA officials, about 46,000 patients had made appointments for private-sector care through the program - a drop in the bucket for a system that averages about 4.7 million appointments per month.
VA officials have been citing modest accomplishments in the campaign to reduce wait times, but they have also said that change won't happen overnight.
According to the VA, the number of appointments completed between May 1 and Feb. 28 was up by nearly 4.5 percent compared to the same period a year earlier. The VA said it has increased the number of vets approved for care in the private sector, though those visits still make up only a tiny percentage of overall care.
Use of the VA system has risen substantially in recent years. Total enrollees in the system ballooned from 6.8 million in 2002 to 8.9 million in 2013. During that same period, outpatient visits have soared from 46.5 million to 86.4 million annually; Patient spending has grown from $19.9 billion to $44.8 billion. The number of patients served annually has grown from 4.5 million to 6 million.