Journal article
Veteran Use of Health Care Systems in Rural States: Comparing VA and Non-VA Health Care Use Among Privately Insured Veterans Under Age 65
The Journal of rural health, Vol.32(4), pp.407-417
09/2016
DOI: 10.1111/jrh.12206
PMID: 27558939
Abstract
To quantify use of VA and non-VA care among working-age veterans with private insurance by linking VA data to private health insurance plan (PHIP) data.
Demographics and utilization were compared between dual users of VA and non-VA systems versus single-system users for veterans < 65 living in 2 rural Midwestern states concurrently enrolled in VA health care and a PHIP for ≥ 1 complete federal fiscal year from 2000 to 2010. Chi-square and t-tests were used for univariate analyses. VA reliance was computed as the percentage of visits, admissions and prescriptions in VA. Multinomial logistic regression was used to compare characteristics by dual use versus non-VA only or VA only use.
Of 16,330 eligible veterans, 54% used both VA and non-VA services, 39% used non-VA only, and 5% used VA only. Compared with single-system use, dual use was associated with older age, priority levels 1-4, service-connected conditions, rural residence, greater years of study eligibility, and enrollment in the PHIP before VA. VA reliance was 33% for outpatient care, 14% for inpatient, and 40% for pharmacy. PHIP data substantially underestimated VA use compared to VA data; 26% who used VA health care had no VA claims in the PHIP dataset.
Over half of working-age veterans enrolled in VA and private insurance used services in both systems. Care coordination efforts across systems should include veterans of all ages, particularly rural veterans more likely to be dual users, and better methods are needed to identify veterans with private insurance and their private providers.
Details
- Title: Subtitle
- Veteran Use of Health Care Systems in Rural States: Comparing VA and Non-VA Health Care Use Among Privately Insured Veterans Under Age 65
- Creators
- Mary E Charlton - Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa. mary-charlton@uiowa.eduMichelle A Mengeling - VA Office of Rural Health, Rural Health Resource Center-Central Region, and the Comprehensive Access and Delivery Research and Evaluation (CADRE), Center at the Iowa City VA Healthcare System, Iowa City, IowaJennifer A Schlichting - Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IowaLan Jiang - VA Center of Innovation in Long-Term Services and Supports for Vulnerable Veterans, Providence VA Healthcare System, Providence, Rhode IslandCarolyn Turvey - Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IowaAmal N Trivedi - Department of Health Services, Policy and Practice and Department of Medicine, Brown University, Providence, Rhode IslandKenneth W Kizer - UC Davis School of Medicine, and Betty Irene Moore School of Nursing, Institute for Population Health Improvement, University of California (UC)-Davis Health System, Sacramento, CaliforniaAlan N West - Office of Rural Health, Veterans Health Administration, Washington, DC
- Resource Type
- Journal article
- Publication Details
- The Journal of rural health, Vol.32(4), pp.407-417
- Publisher
- England
- DOI
- 10.1111/jrh.12206
- PMID
- 27558939
- ISSN
- 0890-765X
- eISSN
- 1748-0361
- Grant note
- DOI: 10.13039/100000738, name: U.S. Department of Veterans Affairs; DOI: 10.13039/100007217, name: Health Services Research and Development
- Language
- English
- Date published
- 09/2016
- Academic Unit
- Psychiatry; Health Management and Policy; Epidemiology; Internal Medicine
- Record Identifier
- 9983996100202771
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