Kazis Lewis E, Miller Donald R, Skinner Katherine M, Lee Austin, Ren Xinhua S, Clark Jack A, Rogers William H, Spiro Avron, Selim Alfredo, Linzer Mark, Payne Susan M, Mansell Dorcas, Fincke R Graeme
Center for Health Quality Outcomes, and Economic Research (CHQOER), Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Mass 01730, USA.
J Ambul Care Manage. 2004 Jan-Mar;27(1):70-83. doi: 10.1097/00004479-200401000-00012.
The goal of the Veterans Health Study (VHS) was to extend the work of the Medical Outcomes Study (MOS) into the VA, by developing methodology for monitoring patient-based outcomes of care for use in ambulatory outpatient care. The principal objective of the VHS was developing valid and reliable measures to assess general health-related quality of life (HRQoL) and identifying the presence of selected health conditions, their severity, and their impact on HRQoL. In this article, we provide an overview of the historical context, framework, objectives, and applications of the VHS for the purpose of assessing the health outcomes of veteran patients. The VHS is a prospective observational study that has followed 2425 VA patients for up to 2 years. The patients were sampled from users of the Veterans Affairs (VA) ambulatory care system in the Boston area. The health conditions selected were hypertension, diabetes, chronic lung disease, osteoarthritis of the knee, chronic low-back pain, and alcohol-related problems. These conditions were chosen because they are both prevalent in the VA and have measurable impacts on HRQoL. One of the cornerstones of the VHS was the development of the Veterans SF-36, modified from the MOS SF-36 for use in veteran ambulatory populations. Other key accomplishments included the development of patient-based disease-specific measures of health and the establishment of methods and logistics for comprehensive health outcomes research in large health care systems such as the VA, using these patient-based measures. Selected measures developed in the VHS, eg, the Veterans SF-36, have been integrated into the VA outcomes measurement system. The scope of the VHS is unique; it resulted in the development of a broad range of patient-focused process and outcome measures, as well as methodologies for assessing large numbers of patients, that have been widely used in the VA outpatient health care system for monitoring health outcomes across the nation.
退伍军人健康研究（VHS）的目标是将医疗结果研究（MOS）的工作扩展到退伍军人事务部（VA），通过开发用于监测门诊患者护理中基于患者的护理结果的方法。VHS的主要目标是制定有效且可靠的措施，以评估与总体健康相关的生活质量（HRQoL），并确定选定健康状况的存在、严重程度及其对HRQoL的影响。在本文中，我们概述了VHS的历史背景、框架、目标和应用，目的是评估退伍军人患者的健康结果。VHS是一项前瞻性观察性研究，对2425名VA患者进行了长达2年的跟踪。这些患者是从波士顿地区退伍军人事务部（VA）门诊护理系统的用户中抽样选取的。选定的健康状况包括高血压、糖尿病、慢性肺病、膝关节骨关节炎、慢性下背痛以及与酒精相关的问题。选择这些状况是因为它们在VA中都很普遍，并且对HRQoL有可测量的影响。VHS的基石之一是对MOS SF - 3量表进行修改后开发的退伍军人SF - 36量表，用于退伍军人门诊人群。其他关键成就包括开发基于患者的特定疾病健康测量方法，以及建立使用这些基于患者的测量方法在诸如VA这样的大型医疗系统中进行全面健康结果研究的方法和后勤保障。VHS中开发的选定测量方法，例如退伍军人SF - 36量表，已被纳入VA结果测量系统。VHS的范围很独特；它促成了广泛的以患者为中心的过程和结果测量方法的开发，以及评估大量患者的方法的开发，这些方法已在VA门诊医疗系统中广泛用于监测全国的健康结果。
