Empirical-Based Typology of Health Care Utilization by Medicare Eligible Veterans
Corresponding Author
Mary Vaughan Sarrazin Ph.D.
Iowa City VA Health Care System, Iowa City, IA
Department of Internal Medicine, University of Iowa, Iowa City, IA
Address correspondence to Mary Vaughan Sarrazin, Ph.D., Iowa City VA Health Care System (152), 601 Highway 6 West, Iowa City, IA 52246, and Department of Internal Medicine, University of Iowa, Iowa City, IA; e-mail: [email protected].Search for more papers by this authorGary E. Rosenthal M.D., F.A.C.P.
Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC
Search for more papers by this authorCarolyn L. Turvey Ph.D.
Comprehensive Access and Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, IA
Department of Psychiatry, University of Iowa, Iowa City, IA
Search for more papers by this authorCorresponding Author
Mary Vaughan Sarrazin Ph.D.
Iowa City VA Health Care System, Iowa City, IA
Department of Internal Medicine, University of Iowa, Iowa City, IA
Address correspondence to Mary Vaughan Sarrazin, Ph.D., Iowa City VA Health Care System (152), 601 Highway 6 West, Iowa City, IA 52246, and Department of Internal Medicine, University of Iowa, Iowa City, IA; e-mail: [email protected].Search for more papers by this authorGary E. Rosenthal M.D., F.A.C.P.
Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC
Search for more papers by this authorCarolyn L. Turvey Ph.D.
Comprehensive Access and Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, IA
Department of Psychiatry, University of Iowa, Iowa City, IA
Search for more papers by this authorAbstract
Objective
Up to 70 percent of patients who receive care through Veterans Health Administration (VHA) facilities also receive care from non-VA providers. Using applied classification techniques, this study sought to improve understanding of how elderly VA patients use VA services and complementary use of non-VA care.
Methods
The study included 1,721,900 veterans age 65 and older who were enrolled in VA and Medicare during 2013 with at least one VA encounter during 2013. Outpatient and inpatient encounters and medications received in VA were classified, and mutually exclusive patient subsets distinguished by patterns of VA service use were derived empirically using latent class analysis (LCA). Patient characteristics and complementary use of non-VA care were compared by patient subset.
Results
Five patterns of VA service use were identified that were distinguished by quantity of VA medical and specialty services, medication complexity, and mental health services. Low VA Medical users tend to be healthier and rely on non-VA services, while High VA users have multiple high cost illnesses and concentrate their care in the VA.
Conclusions
VA patients distinguished by patterns of VA service use differ in illness burden and the use of non-VA services. This information may be useful for framing efforts to optimize access to care and care coordination for elderly VA patients.
Supporting Information
| Filename | Description |
|---|---|
| hesr12995-sup-0001-AppendixSA1.pdfPDF document, 130.8 KB | Appendix SA1: Author Matrix. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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