Dataset Information

Use of outpatient care in Veterans Health Administration and Medicare among veterans receiving primary care in community-based and hospital outpatient clinics.

ABSTRACT:

Objective

To examine differences in use of Veterans Health Administration (VA) and Medicare outpatient services by VA primary care patients.

Data sources/study setting

VA administrative and Medicare claims data from 2001 to 2004.

Study design

Retrospective cohort study of outpatient service use by 8,964 community-based and 6,556 hospital-based VA primary care patients.

Principal findings

A significant proportion of VA patients used Medicare-reimbursed primary care (>30 percent) and specialty care (>60 percent), but not mental health care (3-4 percent). Community-based patients had 17 percent fewer VA primary care visits (p<.001), 9 percent more Medicare-reimbursed visits (p<.001), and 6 percent fewer total visits (p<.05) than hospital-based patients. Community-based patients had 22 percent fewer VA specialty care visits (p<.0001) and 21 percent more Medicare-reimbursed specialty care visits (p<.0001) than hospital-based patients, but no difference in total visits (p=.80).

Conclusions

Medicare-eligible VA primary care patients followed over 4 consecutive years used significant primary care and specialty care outside of VA. Community-based patients offset decreased VA use with increased service use paid by Medicare, suggesting that increasing access to VA primary care via community clinics may fragment veteran care in unintended ways. Coordination of care between VA and non-VA providers and health care systems is essential to improve the quality and continuity of care.

SUBMITTER: Liu CF

PROVIDER: S-EPMC2965504 | biostudies-literature | 2010 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Use of outpatient care in Veterans Health Administration and Medicare among veterans receiving primary care in community-based and hospital outpatient clinics.

Liu Chuan-Fen CF Chapko Michael M Bryson Chris L CL Burgess James F JF Fortney John C JC Perkins Mark M Sharp Nancy D ND Maciejewski Matthew L ML

Health services research 20101001 5 Pt 1

<h4>Objective</h4>To examine differences in use of Veterans Health Administration (VA) and Medicare outpatient services by VA primary care patients.<h4>Data sources/study setting</h4>VA administrative and Medicare claims data from 2001 to 2004.<h4>Study design</h4>Retrospective cohort study of outpatient service use by 8,964 community-based and 6,556 hospital-based VA primary care patients.<h4>Principal findings</h4>A significant proportion of VA patients used Medicare-reimbursed primary care (> ...[more]

PMID: 20831716

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Dataset Information

Use of outpatient care in Veterans Health Administration and Medicare among veterans receiving primary care in community-based and hospital outpatient clinics.

Objective

Data sources/study setting

Study design

Principal findings

Conclusions

Publications

Use of outpatient care in Veterans Health Administration and Medicare among veterans receiving primary care in community-based and hospital outpatient clinics.

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