Department of Veterans Affairs-Medicare dual beneficiaries with stroke: Where do they get care?

Shen, Yujing

doi:10.1682/jrrd.2006.07.0081

Cited by 15 publications

(20 citation statements)

References 15 publications

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“…Prior studies suggest that dual use is more common among patients aged ≥65 years. [29,34] This practice may potentially introduce bias in our study population. First, if dual users are more likely to be hospitalized for infection at non-VA hospitals, the HFI rate will be decreased in the current study.…”

Section: Discussionmentioning

confidence: 99%

TNF-α Antagonist Use and Risk of Hospitalization for Infection in a National Cohort of Veterans With Rheumatoid Arthritis

et al. 2011

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Medications used to treat rheumatoid arthritis (RA) may confer an increased risk of infection. We conducted a retrospective cohort study of veterans with RA followed in the United States Department of Veterans Affairs health care system from October 1998 through June 2005. Risk of hospitalization for infection associated with tumor necrosis factor (TNF)-α antagonists therapy was measured using an extension of Cox proportional hazards regression, adjusting for demographic characteristics, comorbid illnesses, and other medications used to treat RA.

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Section: Discussionmentioning

confidence: 99%

TNF-α Antagonist Use and Risk of Hospitalization for Infection in a National Cohort of Veterans With Rheumatoid Arthritis

et al. 2011

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“…This is consistent with prior studies that have associated dual use with higher income and educational attainment. 14,15 In contrast, class 4 (VA + Medicare prescription users) included more than double the percentage of Medicaid eligible Veterans than class 1 (VA Predominant Users), had the greatest amount of prescription dual users, and received a greater number of prescriptions from Medicare than all other classes. Medicaid enrollment, which enables Veterans to receive their prescriptions at low cost through Medicare Part D, is a significant enticement away from the VA for some Veterans.…”

Section: Discussionmentioning

confidence: 99%

VA and Medicare Utilization Among Dually Enrolled Veterans with Type 2 Diabetes: A Latent Class Analysis

et al. 2016

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Background Many Veterans treated within the VA Healthcare System (VA) are also enrolled in fee-for-service (FFS) Medicare and receive treatment outside the VA. Prior research has not accounted for the multiple ways that Veterans receive services across healthcare systems. Objective To establish a typology of VA and Medicare utilization among dually-enrolled Veterans with type 2 diabetes. Design Retrospective cohort. Participants 316,775 community-dwelling Veterans age ≥65 with type 2 diabetes who were dually-enrolled in the VA and FFS Medicare in 2008–2009. Methods Using latent class analysis, we identified classes of Veterans based upon their probability of using VA and Medicare diabetes care services, including patient visits, laboratory tests, glucose test strips, and medications. We compared amount of healthcare use between classes and identified factors associated with class membership using multinomial regression. Key Results We identified 4 distinct latent classes: class 1 (53.9%) had high probabilities of VA use and low probabilities of Medicare use; classes 2 (17.2%), 3 (21.8%), and 4 (7.0%) had high probabilities of VA and Medicare use, but differed in their Medicare services used. For example, Veterans in class 3 received test strips exclusively through Medicare, while Veterans in class 4 were reliant on Medicare for medications. Living ≥40 miles from a VA predicted membership in classes 3 (OR 1.1, CI 1.06–1.15) and 4 (OR 1.11, CI 1.04–1.18), while Medicaid eligibility predicted membership in class 4 (OR 4.30, CI 4.10–4.51). Conclusions Veterans with diabetes can be grouped into 4 distinct classes of dual health system use, representing a novel way to characterize how patients use multiple services across healthcare systems. This classification has applications for identifying patients facing differential risk from care fragmentation.

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“…In addition, the data warehouse captures some but not all admissions to non-VA hospitals. One study reported that 76% of dually eligible Medicare and VA patients obtained care for their initial stroke at non-VA hospitals, 19 as a result not all veterans admitted to non-VA hospitals may have their data recorded in the data warehouse.…”

Section: Discussionmentioning

confidence: 99%

Using Administrative Databases to Calculate Framingham Scores Within a Large Health Care Organization

Ekundayo

Vassar

Williams

et al. 2011

Stroke

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Department of Veterans Affairs-Medicare dual beneficiaries with stroke: Where do they get care?

Cited by 15 publications

References 15 publications

TNF-α Antagonist Use and Risk of Hospitalization for Infection in a National Cohort of Veterans With Rheumatoid Arthritis

TNF-α Antagonist Use and Risk of Hospitalization for Infection in a National Cohort of Veterans With Rheumatoid Arthritis

VA and Medicare Utilization Among Dually Enrolled Veterans with Type 2 Diabetes: A Latent Class Analysis

Using Administrative Databases to Calculate Framingham Scores Within a Large Health Care Organization

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