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Comprehensive support of family caregivers: Are there health system cost offsets?

Publication ,  Journal Article
Van Houtven, CH; Smith, VA; Stechuchak, KM; Berkowitz, TSZ; Miller, KEM; Shepherd-Banigan, M; Kabat, M; Henius, J
Published in: Health Serv Res
October 2020

OBJECTIVES: To examine the effect of the Department of Veterans Affairs' (VA) Program of Comprehensive Assistance for Caregivers (PCAFC) on total VA health care costs for Veterans. DATA SOURCES: VA claims. STUDY DESIGN: Using a pre-post cohort design with nonequivalent control group, we estimated the effect of PCAFC on total VA costs up through 6 years. The treatment group included Veterans (n = 32 394) whose caregivers enrolled in PCAFC. The control group included an inverse probability of treatment weighted sample of Veterans whose caregivers were denied PCAFC enrollment (n = 38 402). DATA EXTRACTION: May 2009-September 2017. PRINCIPAL FINDINGS: Total VA costs pre-PCAFC application date were no different between groups. Veterans in PCAFC were estimated to have $13 227 in VA costs in the first 6 months post-PCAFC application, compared to $10 806 for controls. Estimated VA costs for both groups decreased in the first 3 years with a narrowing, but persistent and significant, difference, through 5.5 years. No significant difference in VA health care costs existed at 6 years, approximately $10 000 each, though confidence intervals reflect significant uncertainty in cost differences at 6 years. CONCLUSIONS: Increased costs arose from increased outpatient costs of participants. Sample composition changes may explain lack of significance in cost differences at 6 years because these costs comprise of early appliers to PCAFC. Examining 10-year costs could elucidate whether there are long-term cost offsets from increased engagement in outpatient care.

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Published In

Health Serv Res

DOI

EISSN

1475-6773

Publication Date

October 2020

Volume

55

Issue

5

Start / End Page

710 / 721

Location

United States

Related Subject Headings

  • United States Department of Veterans Affairs
  • United States
  • Socioeconomic Factors
  • Middle Aged
  • Mental Health
  • Male
  • Insurance Claim Review
  • Humans
  • Hospital Costs
  • Home Care Services
 

Citation

APA
Chicago
ICMJE
MLA
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Van Houtven, C. H., Smith, V. A., Stechuchak, K. M., Berkowitz, T. S. Z., Miller, K. E. M., Shepherd-Banigan, M., … Henius, J. (2020). Comprehensive support of family caregivers: Are there health system cost offsets? Health Serv Res, 55(5), 710–721. https://doi.org/10.1111/1475-6773.13312
Van Houtven, Courtney Harold, Valerie A. Smith, Karen M. Stechuchak, Theodore S. Z. Berkowitz, Katherine E. M. Miller, Megan Shepherd-Banigan, Margaret Kabat, and Jennifer Henius. “Comprehensive support of family caregivers: Are there health system cost offsets?Health Serv Res 55, no. 5 (October 2020): 710–21. https://doi.org/10.1111/1475-6773.13312.
Van Houtven CH, Smith VA, Stechuchak KM, Berkowitz TSZ, Miller KEM, Shepherd-Banigan M, et al. Comprehensive support of family caregivers: Are there health system cost offsets? Health Serv Res. 2020 Oct;55(5):710–21.
Van Houtven, Courtney Harold, et al. “Comprehensive support of family caregivers: Are there health system cost offsets?Health Serv Res, vol. 55, no. 5, Oct. 2020, pp. 710–21. Pubmed, doi:10.1111/1475-6773.13312.
Van Houtven CH, Smith VA, Stechuchak KM, Berkowitz TSZ, Miller KEM, Shepherd-Banigan M, Kabat M, Henius J. Comprehensive support of family caregivers: Are there health system cost offsets? Health Serv Res. 2020 Oct;55(5):710–721.
Journal cover image

Published In

Health Serv Res

DOI

EISSN

1475-6773

Publication Date

October 2020

Volume

55

Issue

5

Start / End Page

710 / 721

Location

United States

Related Subject Headings

  • United States Department of Veterans Affairs
  • United States
  • Socioeconomic Factors
  • Middle Aged
  • Mental Health
  • Male
  • Insurance Claim Review
  • Humans
  • Hospital Costs
  • Home Care Services