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Inequities in access to VA'S aid and attendance enhanced pension benefit to help Veterans pay for long-term care.

Publication ,  Journal Article
Thomas, KS; Corneau, E; H Van Houtven, C; Cornell, P; Aron, D; M Dosa, D; M Allen, S
Published in: Health Serv Res
June 2021

OBJECTIVE: To examine characteristics that are associated with receipt of Aid and Attendance (A&A), an enhanced pension benefit for Veterans who qualify on the basis of needing daily assistance, among Veterans who receive pensions. DATA SOURCES: Secondary data analysis of 2016-2017 national VA administrative data linked with Medicare claims. STUDY DESIGN: Observational study examining sociodemographic, medical, and healthcare utilization characteristics associated with receipt of A&A among Veterans receiving pension. PRINCIPAL FINDINGS: In 2017, 9.7% of Veterans with pension newly received the A&A benefit. The probability of receiving A&A among black and Hispanic pensioners was 4.6 percentage points lower than for white pensioners (95%CI = -0.051, -0.042). Married Veterans receiving pension had a 4.4-percentage point higher probability of receiving A&A (95%CI = 0.039, 0.048). Most indicators of need for assistance (eg, home health utilization, dementia, stroke) were associated with significantly higher probabilities of receiving A&A, with notable exceptions: pensioners with a diagnosis of Post-Traumatic Stress Disorder (marginal effect = -0.029 95%CI = -0.037, -0.021) or enrolled in Medicaid (marginal effect = -0.053, 95%CI = -0.057, -0.050) had lower probabilities of receiving A&A. Unadjusted and adjusted rates of receiving A&A among Veterans receiving pension varied by VA medical center. CONCLUSIONS: This study identified potential inequities in receipt of the A&A enhanced pension among a sample of Veterans receiving pension. Increased Veteran outreach, provider education, and VA office coordination can potentially reduce inequities in access to this benefit.

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Published In

Health Serv Res

DOI

EISSN

1475-6773

Publication Date

June 2021

Volume

56

Issue

3

Start / End Page

389 / 399

Location

United States

Related Subject Headings

  • Veterans
  • United States Department of Veterans Affairs
  • United States
  • Socioeconomic Factors
  • Sex Factors
  • Pensions
  • Patient Acceptance of Health Care
  • Medicare
  • Long-Term Care
  • Humans
 

Citation

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ICMJE
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Thomas, K. S., Corneau, E., H Van Houtven, C., Cornell, P., Aron, D., M Dosa, D., & M Allen, S. (2021). Inequities in access to VA'S aid and attendance enhanced pension benefit to help Veterans pay for long-term care. Health Serv Res, 56(3), 389–399. https://doi.org/10.1111/1475-6773.13636
Thomas, Kali S., Emily Corneau, Courtney H Van Houtven, Portia Cornell, David Aron, David M Dosa, and Susan M Allen. “Inequities in access to VA'S aid and attendance enhanced pension benefit to help Veterans pay for long-term care.Health Serv Res 56, no. 3 (June 2021): 389–99. https://doi.org/10.1111/1475-6773.13636.
Thomas KS, Corneau E, H Van Houtven C, Cornell P, Aron D, M Dosa D, et al. Inequities in access to VA'S aid and attendance enhanced pension benefit to help Veterans pay for long-term care. Health Serv Res. 2021 Jun;56(3):389–99.
Thomas, Kali S., et al. “Inequities in access to VA'S aid and attendance enhanced pension benefit to help Veterans pay for long-term care.Health Serv Res, vol. 56, no. 3, June 2021, pp. 389–99. Pubmed, doi:10.1111/1475-6773.13636.
Thomas KS, Corneau E, H Van Houtven C, Cornell P, Aron D, M Dosa D, M Allen S. Inequities in access to VA'S aid and attendance enhanced pension benefit to help Veterans pay for long-term care. Health Serv Res. 2021 Jun;56(3):389–399.
Journal cover image

Published In

Health Serv Res

DOI

EISSN

1475-6773

Publication Date

June 2021

Volume

56

Issue

3

Start / End Page

389 / 399

Location

United States

Related Subject Headings

  • Veterans
  • United States Department of Veterans Affairs
  • United States
  • Socioeconomic Factors
  • Sex Factors
  • Pensions
  • Patient Acceptance of Health Care
  • Medicare
  • Long-Term Care
  • Humans