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Costs Associated with Health Care Services Accessed through VA and in the Community through Medicare for Veterans Experiencing Homelessness.
- Source :
- Health Services Research; Dec2018 Supplement S3, Vol. 53, p5352-5374, 23p, 3 Charts, 1 Graph
- Publication Year :
- 2018
-
Abstract
- <bold>Objective: </bold>To estimate health care utilization and costs incurred by homeless Veterans relative to nonhomeless Veterans and to examine the impact of a VA homelessness program on these outcomes.<bold>Data Sources/study Setting: </bold>Combined Department of Veterans Affairs (VA) administrative and Medicare claims data.<bold>Study Design: </bold>Observational study using longitudinal data from Veterans engaged with the VA system and enrolled in Medicare. Veterans with administrative evidence of homelessness at any point during 2006-2010 were matched on period of military service to Veterans with no evidence of homelessness.<bold>Principal Findings: </bold>Experience of homelessness was associated with 1.37 (95 percent CI = 1.34-1.40) and 0.16 (95 percent CI = 0.14-0.17) more outpatient encounters per quarter in VA and non-VA settings, respectively, and 1.31 (95 percent CI = 1.30-1.32) and 0.49 (95 percent CI = 0.48-0.49) more inpatient days per quarter in VA and non-VA hospitals, respectively. These were associated with higher costs. Relative to stably housed Veterans less than 65 years of age, those enrolled in a VA homelessness program had 94.4 percent (95 percent CI = 90.7 percent-98.1 percent) more VA outpatient visits but 5.5 percent (95 percent CI = 3.0 percent-7.9 percent) fewer Medicare outpatient visits.<bold>Conclusions: </bold>Homelessness was associated with an increase in VA and Medicare utilization and cost. A VA homelessness program decreased use of Medicare outpatient services. [ABSTRACT FROM AUTHOR]
- Subjects :
- HEALTH facilities
MEDICAL care
HOMELESSNESS
POVERTY
MEDICARE
HEALTH insurance
ECONOMIC impact
OUTPATIENT medical care
COMPARATIVE studies
HEALTH services accessibility
LONGITUDINAL method
RESEARCH methodology
MEDICAL care costs
MEDICAL cooperation
MENTAL health services
RESEARCH
RESEARCH funding
SOCIOECONOMIC factors
EVALUATION research
PATIENTS' attitudes
ECONOMICS
Subjects
Details
- Language :
- English
- ISSN :
- 00179124
- Volume :
- 53
- Database :
- Complementary Index
- Journal :
- Health Services Research
- Publication Type :
- Academic Journal
- Accession number :
- 133012622
- Full Text :
- https://doi.org/10.1111/1475-6773.13054