Patient Care Activities at the
Michael E. DeBakey VA Medical Center
The Michael
E. DeBakey VA Medical Center, one of the largest VA facilities in
the U.S., serves a 28-county area of southeast Texas with a total veteran
population of 400,000. This facility, with satellite clinics in Beaumont
and Lufkin, has a total enrollment of 50,000 veterans who seek care
here. The MEDVAMC, a state-of-the-art facility completed in 1991, has
478 acute beds, 85 intermediate care beds, and 120 nursing home beds.
Total admissions to this facility the 1996-1997 fiscal year were approximately
13,000.
Medical Service, with 153 acute medicine beds (including 16 MICU/CCU beds) and 55 intermediate care beds, had 6,617 acute admissions in the 1996-1997 fiscal year. Fifty-six Baylor College of Medicine faculty (including geriatrics) oversee patient care and student/resident/fellow training activities in general and subspecialty internal medicine. In the 1996-1997 fiscal year, medicine faculty and trainees saw approximately 40,000 primary care outpatient visits. These medicine faculty practice in multispecialty, multidisciplinary group practices with other health care providers including dietitians, social workers, psychologists and pharmacists.
The Cardiology Section of the Medical Service serves as a VA referral center for treatment of complex cardiology patients and oversees state-of-the-art cardiac catheterization, electrophysiology, and non-invasive labs, an eight-bed cardiac intensive care unit, and a busy consult service. The GI Endoscopy Lab offers all advanced diagnostic and therapeutic treatment modalities including special techniques for hemostasis, drainage of the biliary tree, and removal of common duct stones; dilatation, stent, laser, and thermal methods for obstructing malignancies; small bowel enteroscopy and endoscopic ultrasound.
The Houston Center for Quality of Care and Utilization Studies, created in 1990, is one of nine field programs of the VA Health Services Research and Development Service. A major goal of the Center's research in the area of quality is to enhance the usefulness of large administrative health care databases to assess the quality of care. Major areas of research in 1995 were the assessment of performance of individual VA hospitals, development of new methods for risk-adjusting observational samples, analysis of costs of care for AIDS patients in VA health care facilities, determining whether there is a genetic component to prostate cancer, assessment of the efficacy of arthroscopic surgery for osteoarthritis of the knee in a randomized, placebo-controlled trial, assessment of women veterans' health, and the identification of the determinants of changes in the use of VA inpatient care during the 1980s.
The Medical Service of the
MEDVAMC is actively involved in research, both peer-reviewed and industry-sponsored.
In addition to being fully integrated with the clinical research programs
at Baylor College of Medicine, research at the VA ranges from large
scale clinical trials to cellular and molecular biology. Major themes
of the cardiology research labs include elucidation of the basic mechanisms
responsible for cardiac injury and heart failure, the role of calcium
ATPase gene in compensated and decompensated cardiac hypertrophy, the
role of heat shock proteins in myocardial injury, the role of cytokines
in heart failure, and elucidation of mechanisms for regulating the cell
cycle in cardiac myocytes. Active GI research includes the study of
the molecular epidemiology of GI diseases, the role of Helicobacter
pylori in GI diseases, the genetics of H. pylori, the involvement of
the GI tract in HIV infection, mycobacteria as a possible cause of Crohn's
disease or sarcoidosis, and extrahepatic hepatitis B infection. Many
clinical research protocols are available and include different treatments
for patients with alcoholic cirrhosis of the liver and hepatitis C virus,
new NSAIDs with reduced GI toxicity, and new treatments for H. pylori.
Other areas of research being conducted at the MEDVAMC include molecular
genetics of the platelet von Willebrand factor receptor, regulation
of monocyte function as it affects the pathophysiology of HIV infections,
mechanisms of androgen action at the cellular level, androgen antagonists,
male infertility and prostate biology, regulation of platelet-endothelial
interactions, immunology and molecular biology of Streptococcus pneumoniae,
molecular mechanisms of cell secretion, structure function correlations
of G-proteins, and lung reduction surgery in patients with COPD.
©1995-2004 Baylor College of Medicine
Email: medicine@bcm.tmc.edu
URL: http://www.bcm.tmc.edu/medicine/content_09c.html (Modified: August
18, 2004)
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