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HSR&D 2004 National Meeting Abstracts

1062. Changes in Enrollment in VHA After Media Coverage of Adverse Events
William B Weeks, MD, MBA, White River Junction VAMC, KT Weiser, White River Junction VAMC, PD Mills, White River Junction VAMC

Objectives: We wanted to determine whether newspaper coverage of adverse events that occurred in VHA hospitals was associated with subsequent veteran disenrollment.

Methods: We identified 24 newspaper reports of medical adverse events that occurred between 1994 and 1999 within the VHA. We compared regionally adjusted changes in enrollment rates for facilities that had a reported adverse event to those that did not one year before and one and three years after publication of the newspaper reports.

Results: Facilities that had published newspaper reports of adverse events had lower enrollment rates after publication of the report. For category A veterans, the one- and three-year adjusted enrollment rates were -3.2% and -4.3%; for category C veterans, the one- and three-year adjusted enrollment rates were -4.5% and -14%, respectively. The year prior to publication of the report, facilities with reported adverse events had higher growth rates for both categories of veterans. Facilities that had media coverage of an adverse incident were 3.8 times more likely to have lower than average growth rates for all categories of patients the year after the report(95% CI = 1.519.62) and 2.5 times more likely to be in the lowest quartile for growth three years after the report (95% CI = 1.055.85).

Conclusions: Within the VHA, health care organizations involved in adverse events that generated publicity suffered a greater rate of patient disenrollment.

Impact: If safe patient care practices can reduce adverse publicity, they may enhance corporate value by maintaining enrollment of the patient population.