David Chan, MD, PhD, has won a prestigious award from the National Institute for Health Care Management Foundation for research examining emergency care for elderly veterans at both U.S. Department of Veterans Affairs (VA) and private hospitals.

The NIHCM awards recognize the contributions of researchers and journalists who examine new evidence that advances the health system and the health of Americans.

Chan is a physician, associate professor of health policy, senior fellow at the Stanford Institute for Economic Policy Research (SIEPR), an investigator at the VA, and the 2023 winner of the ASHEcon Medal for his impact to date on the field of health economics.

The study published in the American Economic Review examines care for veterans aged 65 and older who received emergency care provided by the VA and in private hospitals financed by Medicare. The VA provides health for 9 million veterans and its system is the largest integrated health-care delivery system in the country, including 170 medical centers and more than 1,000 outpatient sites.

“Understanding how to provide the best care for veterans between the public and private sectors is an incredibly important policy question,” Chan said. “At least in the emergency department setting, we show that the VA saves lives and money relative to the private sector."

The study cohort included more than 400,000 veterans who were taken by ambulance to either a VA facility or private hospital from 2001 to 2014—and the researchers established a significant VA advantage. The VA reduces 28-day mortality by 46%; the survival gains occur in the first week following the ambulance ride and appear to be long lasting. The VA also reduces total spending by 21% relative to non-VA providers, which indicates higher productivity in the VA than in the private sector.

“We are delighted this award highlights Dave’s landmark research on veterans and their health care, while also promoting the importance of health economics when uncovering the health and financial consequences of policy decisions,” said Doug Owens, MD, chair of the Department of Health Policy. 

Chan and his co-authors—David Card, PhD, of the University of California, Berkeley, and Lowell Taylor, PhD, of Carnegie Mellon University—also found evidence consistent with complementary mechanisms of continuity of care, health IT, and organization. Further, they discovered VA hospitals are overwhelmingly more likely to report lower-cost services than their private counterparts, a finding often indicative of better care coordination.

The research was not only cited by mainstream media such as The New York Times and The Washington Post, it had immediate policy impact. The VA Assistant Under Secretary for Health, the U.S. Congressional Budget Office, and the U.S. Office of Management and Budget requested briefings of the research. The research also was instrumental in halting the planned closure of VA stations by the Asset and Infrastructure Review (AIR) Commission.

“I’m thrilled for David, and this is a well-deserved recognition of his work,” said Mark Duggan, PhD, the Trione Director of SIEPR. “His scholarship is helping shape policy that can improve and prolong the lives of many people.”