Excess mortality at VHA facilities during COVID-19

Editor's Note

This study, led by Boston University and VA Boston Healthcare System, finds a large variation in mortality across Veterans Health Administration (VHA) facilities during the COVID-19 pandemic.

A total of 11.4 million VHA enrollees during 2016 and 2020 were included in the analysis.

Among the findings:

• VHA-enrolled veterans experienced 52,038 excess deaths from March to December 2020, for an excess mortality rate of 16.8%.
• Facility specific rates ranged from -5.5% to +63.7%.
• Facilities in the lowest quartile for excess mortality had fewer COVID-19 deaths and cases per 1,000 population, compared with the highest quartile.
• Facilities in the highest quartile had more hospital beds and a higher percent change in telehealth visits from 2019 to 2020.

The large variation in mortality across VHA facilities during the pandemic was only partially explained by the local COVID-19 burden, the researchers say. The findings provide a framework for identifying changes in facility-level mortality during a public health emergency.