Veterans' Health Care:

VA Needs Better Data on Extent and Causes of Waiting Times

HEHS-00-90: Published: May 31, 2000. Publicly Released: Jun 30, 2000.

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Pursuant to a congressional request, GAO provided information on the Department of Veterans Affairs'(VA) efforts to reduce the waiting times for outpatient care, focusing on VA's initiatives to: (1) improve its waiting time; and (2) address its waiting time problems.

GAO noted that: (1) although VA has begun to collect data systematically on waiting times for outpatient care, it has yet to develop reliable national waiting time data; (2) over the past 10 months, VA has initiated two separate efforts for gathering comprehensive outpatient waiting time data from its facilities; (3) the first effort, initiated in June 1999, produced data that were incomplete and inaccurate, in part because of the differences in facilities' scheduling of appointments; (4) VA's second effort, initiated in December 1999, was designed to improve the data's reliability by measuring the average time taken to schedule an appointment for an entire month; (5) VA officials believe that the new method is significantly better and should provide VA with more complete and accurate data; (6) to ensure this, however, VA will need to overcome some problems identified during implementation, such as inaccurate appointment codes being entered into the system; (7) in addition to taking steps to improve its waiting time data, VA has initiated actions to reduce the time veterans must wait for outpatient appointments; (8) VA hired a private contractor to develop and implement techniques to reduce waiting times at selected clinics in VA facilities nationwide; (9) in addition, VA plans to spend $400 million in fiscal year 2001 to make improvements in the timeliness of service, patient access to telephone care, and timely access to clinical information; (10) however, VA's lack of reliable national waiting time data raises concerns about whether VA has an adequate basis upon which to design these initiatives; (11) specifically, without accurate data on the extent of waiting time problems and analyses of the causes of long waits, VA cannot assess whether its proposed expenditures would reduce waiting times or determine how best to allocate funds to reduce waiting times; and (12) without, reliable baseline waiting time data and a mechanism to track the funds used to improve timeliness of care, VA will not be able to objectively measure whether these funds have actually resulted in reduced waiting times.

Recommendation for Executive Action

  1. Status: Closed - Implemented

    Comments: In June 2002, networks submitted plans for reducing the backlog of veterans waiting for appointments. The networks are now operationalizing those plans, including hiring staff to implement them. Notably, each network has established an electronic wait list, which is tracked monthly and discussed quarterly during network director's performance reviews.

    Recommendation: The Secretary of Veterans Affairs should direct the Under Secretary for Health to first determine the extent of waiting times and their causes and then develop a spending plan that will result in solving the identified waiting time problems. In addition, VA should develop a mechanism for monitoring and tracking expenditures for improving timeliness to evaluate how well targeted funds have reduced waiting times.

    Agency Affected: Department of Veterans Affairs

 

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