The Gerontologist
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Google Scholar
Right arrow Articles by Van Houtven, C. H.
Right arrow Articles by Coffman, C. J.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Van Houtven, C. H.
Right arrow Articles by Coffman, C. J.
The Gerontologist 48:668-678 (2008)
© 2008 The Gerontological Society of America

Home Health Care and Patterns of Subsequent VA and Medicare Health Care Utilization for Veterans

Courtney Harold Van Houtven, PhD1,2, Amy S. Jeffreys, MStat1 and Cynthia J. Coffman, PhD1,3

Correspondence: Address correspondence to Courtney Van Houtven, HSR&D, 508 Fulton Street, Bldg. 16, Durham VAMC, Durham, NC 27705. E-mail: courtney.vanhoutven{at}duke.edu

Purpose: The Veterans Affairs or VA health care system is in the process of significantly expanding home health care (HHC) nationwide. We describe VA HHC use in 2003 for all VA HHC users from 2002; we examine whether VA utilization across a broad spectrum of services differed for a sample of VA HHC users and their propensity-score-matched controls. We also consider crossover between the VA and Medicare. Design and Methods: This is a retrospective study using propensity score and stratified analysis to control for selection bias on observable characteristics. We examined the full cohort of 2002 VA HHC users (n = 24,169) and a 2:1 sample of age- and race-based nonusers (n = 53,356). Utilization measures included VA and Medicare outpatient, inpatient, nursing home, and hospice use, as well as VA home-based primary care, respite care, and adult day health care.  Results: VA HHC users had a higher absolute probability of outpatient use by around 3%, of inpatient use by 12%, and nursing home use by 6% than their propensity-score-matched controls. Implications: Veterans who used HHC services had a higher rate of VA service use in the subsequent year than controls did, even after we adjusted for differences in observed health status, eligibility advantages, and supplemental insurance status. High utilization for VA home health users spilled over into high Medicare utilization.

Key Words: Formal home care • Health care services use • Stratified analysis • Veterans






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
All GSA journals Journals of Gerontology Series A: Biological Sciences and Medical Sciences Journals of Gerontology Series B: Psychological Sciences and Social Sciences
Copyright © 2008 by The Gerontological Society of America.