VAMHCSVeterans Affairs Maryland Health Care System
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For FY 1999-FY 2008, a mean ([+ or -] SD) of 48,940 ([+ or -] 3,926) unique veterans accessed care in the VAMHCS each year.
First, the VAMHCS population of adult, mostly male patients living in the mid-Atlantic region does not fully represent the overall US population.
Most of the VAMHCS nursing turnover is now caused by retirements and transfers rather than resignations or removals.
* Requests from outside medical facilities to transfer a veteran to the VAMHCS. * Difficulties with patient ownership, such as one service saying it will take a patient and later backing out.
For SSTIs, the total number of ECS visits (n = 3,688) and VAMHCS visits (n = 13,041) per FY, according to codes from the International Classification of Disease, Clinical Modification 9 (ICD-9-CM) (680, carbuncle and furuncle; 681, cellulitis and abscess of finger and toe; 682, other cellulitis and abscess; 704.8, folliculitis), were obtained from administrative records.
Because of concerns that there may have been shifts in where care was delivered within our healthcare system, we also examined the number and rate of SSTIs for the entire VAMHCS. Absolute numbers of visits increased, with 2,020 visits in FY01, 1,972 in FY02, 2,190 in FY03, 3,337 in FY04, and 3,522 in FY05.
We selected two controls per case from patients admitted to a VAMHCS institution for at least 48 hours during the same 6-month period as the case-patients.