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Use of outpatient care in VA and Medicare among disability-eligible and age-eligible veteran patients.

Publication ,  Journal Article
Liu, C-F; Bryson, CL; Burgess, JF; Sharp, N; Perkins, M; Maciejewski, ML
Published in: BMC Health Serv Res
March 5, 2012

BACKGROUND: More than half of veterans who use Veterans Health Administration (VA) care are also eligible for Medicare via disability or age, but no prior studies have examined variation in use of outpatient services by Medicare-eligible veterans across health system, type of care or time. OBJECTIVES: To examine differences in use of VA and Medicare outpatient services by disability-eligible or age-eligible veterans among veterans who used VA primary care services and were also eligible for Medicare. METHODS: A retrospective cohort study of 4,704 disability- and 10,816 age-eligible veterans who used VA primary care services in fiscal year (FY) 2000. We tracked their outpatient utilization from FY2001 to FY2004 using VA administrative and Medicare claims data. We examined utilization differences for primary care, specialty care, and mental health outpatient visits using generalized estimating equations. RESULTS: Among Medicare-eligible veterans who used VA primary care, disability-eligible veterans had more VA primary care visits (p < 0.001) and more VA specialty care visits (p < 0.001) than age-eligible veterans. They were more likely to have mental health visits in VA (p < 0.01) and Medicare-reimbursed visits (p < 0.01). Disability-eligible veterans also had more total (VA+Medicare) visits for primary care (p < 0.01) and specialty care (p < 0.01), controlling for patient characteristics. CONCLUSIONS: Greater use of primary care and specialty care visits by disability-eligible veterans is most likely related to greater health needs not captured by the patient characteristics we employed and eligibility for VA care at no cost. Outpatient care patterns of disability-eligible veterans may foreshadow care patterns of veterans returning from Afghanistan and Iraq wars, who are entering the system in growing numbers. This study provides an important baseline for future research assessing utilizations among returning veterans who use both VA and Medicare systems. Establishing effective care coordination protocols between VA and Medicare providers can help ensure efficient use of taxpayer resources and high quality care for disabled veterans.

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Published In

BMC Health Serv Res

DOI

EISSN

1472-6963

Publication Date

March 5, 2012

Volume

12

Start / End Page

51

Location

England

Related Subject Headings

  • Veterans Disability Claims
  • Veterans
  • Utilization Review
  • United States
  • Specialization
  • Retrospective Studies
  • Primary Health Care
  • Middle Aged
  • Mental Health Services
  • Medicare
 

Citation

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Chicago
ICMJE
MLA
NLM
Liu, C.-F., Bryson, C. L., Burgess, J. F., Sharp, N., Perkins, M., & Maciejewski, M. L. (2012). Use of outpatient care in VA and Medicare among disability-eligible and age-eligible veteran patients. BMC Health Serv Res, 12, 51. https://doi.org/10.1186/1472-6963-12-51
Liu, Chuan-Fen, Chris L. Bryson, James F. Burgess, Nancy Sharp, Mark Perkins, and Matthew L. Maciejewski. “Use of outpatient care in VA and Medicare among disability-eligible and age-eligible veteran patients.BMC Health Serv Res 12 (March 5, 2012): 51. https://doi.org/10.1186/1472-6963-12-51.
Liu C-F, Bryson CL, Burgess JF, Sharp N, Perkins M, Maciejewski ML. Use of outpatient care in VA and Medicare among disability-eligible and age-eligible veteran patients. BMC Health Serv Res. 2012 Mar 5;12:51.
Liu, Chuan-Fen, et al. “Use of outpatient care in VA and Medicare among disability-eligible and age-eligible veteran patients.BMC Health Serv Res, vol. 12, Mar. 2012, p. 51. Pubmed, doi:10.1186/1472-6963-12-51.
Liu C-F, Bryson CL, Burgess JF, Sharp N, Perkins M, Maciejewski ML. Use of outpatient care in VA and Medicare among disability-eligible and age-eligible veteran patients. BMC Health Serv Res. 2012 Mar 5;12:51.
Journal cover image

Published In

BMC Health Serv Res

DOI

EISSN

1472-6963

Publication Date

March 5, 2012

Volume

12

Start / End Page

51

Location

England

Related Subject Headings

  • Veterans Disability Claims
  • Veterans
  • Utilization Review
  • United States
  • Specialization
  • Retrospective Studies
  • Primary Health Care
  • Middle Aged
  • Mental Health Services
  • Medicare