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Highlights

Hepatitis C is a chronic disease caused by a blood-borne virus that can lead to potentially fatal liverrelated conditions. In 2001, GAO reported that the VA missed opportunities to test about 50 percent of veterans identified as at risk for hepatitis C. GAO was asked to (1) review VA's fiscal year 2002 performance measurement results in testing veterans at risk for hepatitis C, (2) identify factors that impede VA's efforts to test veterans for hepatitis C, and (3) identify actions taken by VA networks and medical facilities to improve the testing rate of veterans at risk for hepatitis C. GAO reviewed VA's fiscal year 2002 hepatitis C performance results and compared them against VA's national performance goals, interviewed headquarters and field officials in three networks, and conducted a case study in one network.

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Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Veterans Affairs 1. To improve VA's testing of veterans identified as at risk of hepatitis C infection, the Secretary of Veterans Affairs should direct the Under Secretary for Health to determine the effectiveness of actions taken by networks and facilities to improve the hepatitis C testing rates for veterans and, where actions have been successful, consider applying these improvements systemwide.
Closed - Implemented
VA network officials were briefed in April 2004 regarding practices in networks with the highest hepatitis C testing rates. VA's external peer review program data show that VA's rates of testing at risk patients are high. In fiscal year 2005, based on a sample of 16,000 veterans receiving care at VA medical facilities, 98 percent had been screened for hepatitis C risk factors and 93 percent of the approximately 8,000 veterans with risk factors had been tested or diagnosed with the hepatitis C virus.
Department of Veterans Affairs 2. To improve VA's testing of veterans identified as at risk of hepatitis C infection, the Secretary of Veterans Affairs should direct the Under Secretary for Health to provide local managers with information on current fiscal year performance results using a subset of the performance measurement sample of veterans in order for them to determine the effectiveness of actions taken to improve hepatitis C testing processes.
Closed - Implemented
VA's external peer review program data show that VA's rates of testing at risk patients are high. In fiscal year 2005, based on a sample of 16,000 veterans receiving care at VA medical facilities, 98 percent had been screened for hepatitis C risk factors and 93 percent of the approximately 8,000 veterans with risk factors had been tested or diagnosed with the hepatitis C virus. VA stated that it is seldom possible to drive performance quality indicators higher than what its medical facilities have achieved. Additionally, VA has found that the predicted rate of undetected hepatitis C infection among veterans in VA care is well under 1 percent.

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