Differences in use of Veterans Health Administration and non-Veterans Health Administration hospitals by rural and urban Veterans after access expansions.

التفاصيل البيبلوغرافية
العنوان:	Differences in use of Veterans Health Administration and non-Veterans Health Administration hospitals by rural and urban Veterans after access expansions.
المؤلفون:	Dizon MP; Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Menlo Park, California, USA.; Department of Health Policy, Stanford University School of Medicine, Stanford, California, USA., Kizer KW; Stanford University School of Medicine, Stanford, California, USA., Ong MK; Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.; David Geffen School of Medicine and Fielding School of Public Health, University of California at Los Angeles, Los Angeles, California, USA., Phibbs CS; Department of Health Policy, Stanford University School of Medicine, Stanford, California, USA.; Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA.; Health Economics Resource Center, Veterans Affairs Palo Alto Health Care System, Menlo Park, California, USA., Vanneman ME; Informatics, Decision-Enhancement and Analytic Sciences Center, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA.; Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.; Division of Health System Innovation and Research, Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, Utah, USA., Wong EP; Health Economics Resource Center, Veterans Affairs Palo Alto Health Care System, Menlo Park, California, USA., Zhang Y; Informatics, Decision-Enhancement and Analytic Sciences Center, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA.; Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.; Division of Biostatistics, Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, Utah, USA., Yoon J; Health Economics Resource Center, Veterans Affairs Palo Alto Health Care System, Menlo Park, California, USA.; Department of General Internal Medicine, School of Medicine, University of California at San Francisco, San Francisco, California, USA.
المصدر:	The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association [J Rural Health] 2024 Jun; Vol. 40 (3), pp. 446-456. Date of Electronic Publication: 2023 Nov 30.
نوع المنشور:	Journal Article
اللغة:	English
بيانات الدورية:	Publisher: Blackwell Country of Publication: England NLM ID: 8508122 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1748-0361 (Electronic) Linking ISSN: 0890765X NLM ISO Abbreviation: J Rural Health Subsets: MEDLINE
أسماء مطبوعة:	Publication: [Oxford, Eng.] : Blackwell Original Publication: [Burlington, Vt.?] : Journal of Rural Health, c1985-
مواضيع طبية MeSH:	Veterans/statistics & numerical data , Rural Population/statistics & numerical data , United States Department of Veterans Affairs/statistics & numerical data , United States Department of Veterans Affairs/organization & administration , Health Services Accessibility/statistics & numerical data , Health Services Accessibility/standards , Urban Population*/statistics & numerical data, Humans ; United States ; Male ; Female ; Middle Aged ; Cross-Sectional Studies ; Aged ; Adult ; Hospitals, Veterans/statistics & numerical data
مستخلص:	Purpose: To examine changes in rural and urban Veterans' utilization of acute inpatient care in Veterans Health Administration (VHA) and non-VHA hospitals following access expansion from the Veterans Choice Act, which expanded eligibility for VHA-paid community hospitalization. Methods: Using repeated cross-sectional data of VHA enrollees' hospitalizations in 9 states (AZ, CA, CT, FL, LA, MA, NY, PA, and SC) between 2012 and 2017, we compared rural and urban Veterans' probability of admission in VHA and non-VHA hospitals by payer over time for elective and nonelective hospitalizations using multinomial logistic regression to adjust for patient-level sociodemographic features. We also used generalized linear models to compare rural and urban Veterans' travel distances to hospitals. Findings: Over time, the probability of VHA-paid community hospitalization increased more for rural Veterans than urban Veterans. For elective inpatient care, rural Veterans' probability of VHA-paid admission increased from 2.9% (95% CI 2.6%-3.2%) in 2012 to 6.5% (95% CI 5.8%-7.1%) in 2017. These changes were associated with a temporal trend that preceded and continued after the implementation of the Veterans Choice Act. Overall travel distances to hospitalizations were similar over time; however, the mean distance traveled decreased from 39.2 miles (95% CI 35.1-43.3) in 2012 to 32.3 miles (95% CI 30.2-34.4) in 2017 for rural Veterans receiving elective inpatient care in VHA-paid hospitals. Conclusions: Despite limited access to rural hospitals, these data demonstrate an increase in rural Veterans' use of non-VHA hospitals for acute inpatient care and a small reduction in distance traveled to elective inpatient services. (Published 2023. This article is a U.S. Government work and is in the public domain in the USA.)
References:	Rural Veterans. US Department of Veterans Affairs, Office of Rural Health; 2023. Accessed September 19, 2023. Available at: https://www.ruralhealth.va.gov/aboutus/ruralvets.asp. Randolph R, Thomas S, Holmes M, et al. Rural Population Health in the United States: A Chartbook. North Carolina Rural Health Research Program, Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill; 2023. Accessed April 18, 2023. Available at: https://www.ruralhealthresearch.org/publications/1572. Ohl ME, Carrell M, Thurman A, et al. Availability of healthcare providers for rural veterans eligible for purchased care under the Veterans Choice Act. BMC Health Serv Res. 2018;18:315. Kizer KW, Dudley RA. Extreme makeover: transformation of the veterans health care system. Annu Rev Public Health. 2009;30:313‐339. Mengeling MA, Charlton M. Rural Veterans’ Use of CBOCs for Primary Care: FY07. US Department of Veterans Affairs, Veterans Rural Health Resource Center–Central Region; VHA Office of Rural Health; 2012. Accessed April 18, 2023. Available at: http://www.ruralhealth.va.gov/publications.asp. Spotlight on Telehealth. US Department of Veterans Affairs, Health Services Research & Development; 2020. Accessed April 18, 2023. Available from: https://www.hsrd.research.va.gov/news/feature/telehealth‐0720.cfm. Cowper RD, Ahern J, Litt E, Wilson L. Rural Veterans Health Care Atlas, 2nd Edition FY‐2015. Washington, DC: US Department of Veterans Affairs, VHA Office of Rural Health. Accessed February 28, 2023. Available from: https://www.ruralhealth.va.gov/aboutus/rvhc_atlas_fy2015.asp. Wang JZ, Dhanireddy P, Prince C, et al. 2021 Survey of Veteran Enrollees’ Health and Use of Health Care—Data Findings Report. US Department of Veterans Affairs; 2021. Veterans’ Benefits Act of 1957 (H.R. 53, P.L. 85‐56; 71 Stat. 110). The Veterans Millennium Health Care and Benefits Act. Department of Veterans Affairs. Final rule. Fed Regist. 2000;65(136):43699‐43700. Department of Veterans Affairs. Payment of reimbursement for emergency treatment furnished by non‐VA providers in non‐VA facilities to certain veterans with service‐connected or nonservice‐connected disabilities. Final rule. Fed Regist. 2011;76(245):79067‐79072. VA Health Care: Management and Oversight of Fee Basis Care Need Improvement. US Government Accountability Office; 2013. Accessed April 18, 2023. Available from: https://www.gao.gov/products/gao‐13‐441. Department of Veterans Affairs. Expanded access to non‐VA care through the Veterans Choice Program. Final rule. Fed Regist. 2015;80(209):66419‐66429. Bass E, Mosher D, Keating EG, et al. The Veterans Community Care Program: Background and Early Effects. Congressional Budget Office; 2021. Accessed October 17, 2022. Available from: https://www.cbo.gov/publication/57583. Gordon SH, Beilstein‐Wedel E, Rosen AK, et al. County‐level predictors of growth in community‐based primary care use among veterans. Med Care. 2021;59(6):S301‐S306. Gurewich D, Shwartz M, Beilstein‐Wedel E, Davila H, Rosen AK. Did access to care improve since passage of the Veterans Choice Act?: differences between rural and urban veterans. Med Care. 2021;59(3):S270‐S278. Wishner J, Solleveld P, Rudowitz R, Paradise J, Antonisse L. A Look at Rural Hospital Closures and Implications for Access to Care: Three Case Studies. Kaiser Family Foundation; 2016. Cosgrove J, Giusto G, Binkowski A, et al. Hospital Closures Threaten Patient Access to Care as Hospitals Face a Range of Rising Pressures. American Hospital Association; 2022. Rural Hospital Closures: Number and Characteristics of Affected Hospitals and Contributing Factors. US Government Accountability Office; 2018. Accessed May 4, 2023. Available from: https://www.gao.gov/products/gao‐18‐634. Examining Rural Hospital Bypass for Inpatient Services. Baltimore, MD: Centers for Medicare & Medicaid Services, Office of Minority Health; 2020. Mooney C, Zwanziger J, Phibbs CS, Schmitt S. Is travel distance a barrier to veterans’ use of VA hospitals for medical surgical care? Soc Sci Med. 2000;50(12):1743‐1755. Health Economics Resource Center. Observational Medical Outcomes Partnership (OMOP). Accessed June 15, 2023. Available from: https://www.herc.research.va.gov/include/page.asp?id=omop. VA Priority Groups. US Department of Veterans Affairs; 2022. Accessed May 17, 2023. Available from: https://www.va.gov/health‐care/eligibility/priority‐groups/. US Department of Agriculture. Economic Research Service. Rural‐Urban Continuum Codes. Accessed May 2, 2023. Available from: https://www.ers.usda.gov/data‐products/rural‐urban‐continuum‐codes/. Bayoumi AM. STDDIFF: Stata Module to Compute Standardized Differences for Continuous and Categorical Variables. 2016. Accessed September 6, 2023. Available from: https://ideas.repec.org/c/boc/bocode/s458275.html. Zhang Z, Kim HJ, Lonjon G, Zhu Y. Balance diagnostics after propensity score matching. Ann Transl Med. 2019;7(1):16. Rogers W. Regression standard errors in clustered samples. Stata Tech Bull. 1994;3(13):19‐23. Buzza C, Ono SS, Turvey C, et al. Distance is relative: unpacking a principal barrier in rural healthcare. J Gen Intern Med. 2011;26(2):648‐654. Wakefield BJ, Tripp‐Reimer T, Rosenbaum ME, Rosenthal GE. Veterans’ use of Department of Veterans Affairs care and perceptions of outsourcing inpatient care. Mil Med. 2007;172(6):565‐571. Actions Needed to Improve Administration and Oversight of Veterans’ Millennium Act Emergency Care Benefit. US Government Accountability Office; 2014. Accessed September 20, 2023. Available from: https://www.gao.gov/assets/gao‐14‐175.pdf. Institute of Medicine. Interpreting the Volume–Outcome Relationship in the Context of Health Care Quality: Workshop Summary. National Academies Press; 2000. West AN, Weeks WB, Charlton ME. Differences among states in rural veterans’ use of VHA and non‐VHA hospitals. J Rural Health. 2017;33(1):32‐40. Kizer K, Pane G, Shiplett M. Veterans Health Administration Fee Care Program. National Academy of Public Administration. Accessed May 4, 2023. Available from: https://napawash.org/academy‐studies/veterans‐health‐administration‐fee‐care‐program. Boudreaux M, Barath D, Blewett LA. Recent changes in health insurance coverage for urban and rural veterans: evidence from the first year of the Affordable Care Act. Mil Med. 2019;184(1‐2):e76‐e82. Rudowitz R, Burns A, Hinton E, Mohamed M. 10 Things to Know About Medicaid. Kaiser Family Foundation; 2023. Congressional Budget Office Cost Estimate, H.R. 5674 VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018. Congressional Budget Office; 2018. Birkmeyer JD, Barnato A, Birkmeyer N, Bessler R, Skinner J. The impact of the COVID‐19 pandemic on hospital admissions in the United States: study examines trends in US hospital admissions during the COVID‐19 pandemic. Health Aff. 2020;39(11):2010‐2017. Heist T, Schwartz K, Butler S. Trends in Overall and Non‐COVID‐19 Hospital Admissions. 2021. Accessed September 13, 2023. Available from: https://www.kff.org/health‐costs/issue‐brief/trends‐in‐overall‐and‐non‐covid‐19‐hospital‐admissions/. Mehta A, Awuah WA, Ng JC, et al. Elective surgeries during and after the COVID‐19 pandemic: case burden and physician shortage concerns. Ann Med Surg. 2022;81:104395. Levinson Z, Godwin J, Hulver S. Rural Hospitals Face Renewed Financial Challenges, Especially in States That Have Not Expanded Medicaid. Kaiser Family Foundation; 2023. Mattingly AS, Eddington HS, Rose L, et al. Defining essential surgery in the US during the COVID‐19 pandemic response. JAMA Surg. 2023;158(1):99‐100. The Impact of the Pandemic on Rural Hospitals. Center for Healthcare Quality & Payment Reform; 2023.
معلومات مُعتمدة:	I01 HX002653 United States HX HSRD VA; #IHX002653-01A1 Veterans Affairs Health Services Research and Development; #1IK2HX002625 Veterans Affairs Health Services Research and Development
فهرسة مساهمة:	Keywords: access to care; health services research; hospitals; medical care; utilization of health services
تواريخ الأحداث:	Date Created: 20231130 Date Completed: 20240619 Latest Revision: 20240621
رمز التحديث:	20240621
مُعرف محوري في PubMed:	PMC11136881
DOI:	10.1111/jrh.12812
PMID:	38036456
قاعدة البيانات:	MEDLINE

View record at Wiley

Full Text Finder

الوصف
تدمد:	1748-0361
DOI:	10.1111/jrh.12812