Bazos D, David B, Bazos D, Weeks W, Lamkin R, Wright S; AcademyHealth. Meeting (2003 : Nashville, Tenn.).
Abstr AcademyHealth Meet. 2003; 20: abstract no. 674.
White River Junction VA, Rural Health Initiatives, 215 North Main Street, White River Junction, VT 05009 Tel. (802) 295-9363 x6943 Fax (802) 291-6286
RESEARCH OBJECTIVE: To examine veterans who have access to multiple systems of care, e.g., VA and Medicare, and assess whether their utilization patterns for Coronary Artery Bypass Grafting (CABG) surgery were influenced by the availability of local care. STUDY DESIGN: We identified two age groups (45-64 and 65+) and used ZIP code of residence to determine whether each veteran lived in an HRR that contained a regional VHA CABG program in West Roxbury, MA or West Haven, CT (VHA HRR) or not. Using ICD-9 codes, we identified VHA and Medicare funded CABGs. We used t-test analysis to compare utilization rates for veterans who lived in a VHA HRR to those who did not. POPULATION STUDIED: VHA enrolled veterans who received care exclusively in New England (VHA VISN 1) from 1997 through 1999. PRINCIPAL FINDINGS: 15% of enrolled veterans in both age cohorts lived in a VHA HRR. Veterans who lived in a VHA HRR had a higher rate of VHA CABG utilization that those who did not (45-64 year old group: 13.28 CABGS per 1000 enrolled veterans for VHA HRR residents vs. 12.56, p<.0001; 65+ group, 14.54 vs. 14.08, p<.0001). In the younger age group, veterans who lived in a VHA HRR had a lower rate of Medicare CABG utilization (2.2.8 vs. 2.44, p<.0001); in the older age group the opposite was found (21.45 vs. 19.59, p<.0001). CONCLUSIONS: Veterans who did not live in a VHA HRR had lower VHA CABG utilization rates. When veterans became age-eligible for Medicare, they were much more likely to use Medicare compared to VHA, regardless of residence. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: Regionalized services may implicitly restrict access to care for veterans. VHA should consider local patterns of care and different care delivery models to facilitate service access.
Publication Types:
Keywords:
- Coronary Artery Bypass
- Hospitals, Veterans
- Medicare
- New England
- Veterans
- economics
- surgery
- utilization
- hsrmtgs
Other ID:
UI: 102275644
From Meeting Abstracts