Journal article
Dual-System Use and Intermediate Health Outcomes among Veterans Enrolled in Medicare Advantage Plans
Health services research, Vol.50(6), pp.1868-1890
12/2015
DOI: 10.1111/1475-6773.12303
PMCID: PMC4693838
PMID: 25845818
Abstract
The concurrent use of multiple health care systems may duplicate or fragment care. We assessed the characteristics of veterans who were dually enrolled in both the Veterans Affairs (VA) health care system and a Medicare Advantage (MA) plan, and compared intermediate quality outcomes among those exclusively receiving care in the VA with those receiving care in both systems.
VA and MA quality and administrative data from 2008 to 2009.
We used propensity score methods to test the association between dual use and five intermediate outcome quality measures. Outcomes included control of cholesterol, blood pressure, and glycosylated hemoglobin among persons with coronary heart disease (CHD), hypertension, and diabetes.
VA and MA data were merged to identify VA-only users (n = 1,637) and dual-system users (n = 5,006).
We found no significant differences in intermediate outcomes between VA-only and dual-user populations. Differences ranged from a 3.2 percentage point (95 percent CI: -1.8 to 8.2) greater rate of controlled cholesterol among VA-only users with CHD to a 2.2 percentage point (95 percent CI: -2.4 to 6.6) greater rate of controlled blood pressure among dual users with diabetes.
For the five measures studied, we did not find evidence that veterans with dual use of VA and MA care experienced improved or worsened outcomes as compared with veterans who exclusively used VA care.
Details
- Title: Subtitle
- Dual-System Use and Intermediate Health Outcomes among Veterans Enrolled in Medicare Advantage Plans
- Creators
- Alicia L Cooper - Department of Vermont Health Access, Williston, VTLan Jiang - Research Enhancement Award Program, Providence VA Medical Center, Providence, RIJean Yoon - Health Economics Resource Center and Center for Innovation to Implementation, Palo Alto VA Medical Center, Palo Alto, CAMary E Charlton - Department of Epidemiology, University of Iowa, Iowa City, IAIra B Wilson - Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RIVincent Mor - Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RIKenneth W Kizer - Institute for Population Health Improvement, University of California Davis Health System, Sacramento, CAAmal N Trivedi - Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI
- Resource Type
- Journal article
- Publication Details
- Health services research, Vol.50(6), pp.1868-1890
- Publisher
- United States
- DOI
- 10.1111/1475-6773.12303
- PMID
- 25845818
- PMCID
- PMC4693838
- ISSN
- 1475-6773
- eISSN
- 1475-6773
- Grant note
- name: VA Health Services Research & Development (HSR&D) Service
- Language
- English
- Date published
- 12/2015
- Academic Unit
- Health Management and Policy; Epidemiology
- Record Identifier
- 9983996098002771
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