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Health Aff (Millwood). 2019 Jun;38(6):1037-1045. doi: 10.1377/hlthaff.2019.00020.

Users Of Veteran-Directed Care And Other Purchased Care Have Similar Hospital Use And Costs Over Time.

Author information

1
Yingzhe Yuan is a data analyst at the Partnered Evidence-Based Policy Resource Center at the Veterans Affairs (VA) Boston Healthcare System and a research assistant at the Boston University School of Public Health, both in Massachusetts.
2
Kali S. Thomas is a research health scientist in the Center of Innovation in Long-Term Services and Supports at the Providence VA Medical Center and an associate professor in the Center for Gerontology and Healthcare Research, Brown University School of Public Health, all in Providence, Rhode Island.
3
Austin B. Frakt is director of the Partnered Evidence-Based Policy Resource Center at the VA Boston Healthcare System; an associate professor in the Boston University School of Public Health; and an adjunct associate professor at the Harvard T. H. Chan School of Public Health, all in Boston.
4
Steven D. Pizer is chief economist of the Partnered Evidence-Based Policy Resource Center at the VA Boston Healthcare System and an associate professor of health law, policy, and management, Boston University School of Public Health.
5
Melissa M. Garrido ( melissa.garrido@va.gov ) is associate director of the Partnered Evidence-Based Policy Resource Center at the VA Boston Healthcare System and an associate professor of health law, policy, and management, Boston University School of Public Health.

Abstract

The Veteran-Directed Care (VDC) program facilitates independent community living among adults with multiple chronic conditions and functional limitations. Family caregivers value the choice and flexibility afforded by VDC, but rigorous evidence to support its impact on health care costs and use is needed. We identified veterans enrolled in VDC in fiscal year 2017 and investigated differences in hospital admissions and costs after initial receipt of VDC services. We compared VDC service recipients to a matched comparison group of veterans receiving homemaker or home health aide, home respite, and adult day health care services and found similar decreases in hospital use and costs from before to after enrollment in the groups. Further investigation into trends of nursing home use, identification of veterans most likely to benefit from VDC, and relative costs of operating VDC versus other purchased care programs is needed, but our results suggest that VDC remains a valuable option for supporting veterans and caregivers.

KEYWORDS:

Caregivers; Veterans; costs; older adults; participant-directed care; workforce

PMID:
31158026
DOI:
10.1377/hlthaff.2019.00020

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