Comprehensive Support for Family Caregivers: Impact on Veteran Health Care Utilization and Costs

被引:44
作者
Van Houtven, Courtney Harold [1 ,2 ]
Smith, Valerie A. [1 ,2 ]
Stechuchak, Karen M. [1 ]
Shepherd-Banigan, Megan [1 ]
Hastings, Susan Nicole [1 ,2 ,3 ]
Maciejewski, Matthew L. [1 ,2 ]
Wieland, Gilbert Darryl [1 ]
Olsen, Maren K. [1 ,3 ]
Miller, Katherine E. M. [1 ]
Kabat, Margaret [4 ]
Henius, Jennifer [4 ]
Campbell-Kotler, Margaret [4 ]
Oddone, Eugene Z. [1 ,2 ]
机构
[1] Durham VA Med Ctr, Durham, NC USA
[2] Duke Univ, Med Ctr, Durham, NC USA
[3] Duke Univ, Durham, NC USA
[4] VA Caregiver Support Program, Washington, DC USA
关键词
informal care; family caregivers; primary care; mental health outpatient care; emergency department; inpatient hospitalization; Veterans health care utilization; PROPENSITY SCORE; SYSTEMS;
D O I
10.1177/1077558717697015
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
This study aimed to examine the early impact of the Program of Comprehensive Assistance for Family Caregivers (PCAFC) on Veteran health care utilization and costs. A pre-post cohort design including a nonequivalent control group was used to understand how Veterans' use of Veteran Affairs health care and total health care costs changed in 6-month intervals up to 3 years after PCAFC enrollment. The control group was an inverse probability of treatment weighted sample of Veterans whose caregivers applied for, but were not accepted into, PCAFC. Veterans in PCAFC had similar acute care utilization postenrollment when compared with those in the control group, but significantly greater primary, specialty, and mental health outpatient care use at least 30, and up to 36, months postenrollment. Estimated total health care costs for PCAFC Veterans were $1,500 to $3,400 higher per 6-month interval than for control group Veterans. PCAFC may have increased Veterans' access to care.
引用
收藏
页码:89 / 114
页数:26
相关论文
共 31 条
  • [1] Alliance for the Betterment of Citizens with Disabilities, 2016, SUPP FAM CAR VIA FED
  • [2] [Anonymous], BLUEPR EXC
  • [3] Ash AS, 2000, HEALTH CARE FINANC R, V21, P7
  • [4] A Tutorial and Case Study in Propensity Score Analysis: An Application to Estimating the Effect of In-Hospital Smoking Cessation Counseling on Mortality
    Austin, Peter C.
    [J]. MULTIVARIATE BEHAVIORAL RESEARCH, 2011, 46 (01) : 119 - 151
  • [5] Balance diagnostics for comparing the distribution of baseline covariates between treatment groups in propensity-score matched samples
    Austin, Peter C.
    [J]. STATISTICS IN MEDICINE, 2009, 28 (25) : 3083 - 3107
  • [6] Variable selection for propensity score models
    Brookhart, M. Alan
    Schneeweiss, Sebastian
    Rothman, Kenneth J.
    Glynn, Robert J.
    Avorn, Jerry
    Sturmer, Til
    [J]. AMERICAN JOURNAL OF EPIDEMIOLOGY, 2006, 163 (12) : 1149 - 1156
  • [7] Squeezing the Balloon: Propensity Scores and Unmeasured Covariate Balance
    Brooks, John M.
    Ohsfeldt, Robert L.
    [J]. HEALTH SERVICES RESEARCH, 2013, 48 (04) : 1487 - 1507
  • [8] Consumer-directed heath care: Early evidence about effects on cost and quality
    Buntin, Melinda Beeuwkes
    Damberg, Cheryl
    Haviland, Amelia
    Kapur, Kanika
    Lurie, Nicole
    McDevitt, Roland
    Marquis, M. Susan
    [J]. HEALTH AFFAIRS, 2006, 25 (06) : W516 - W530
  • [9] Feinberg Lynn Friss, 2006, J Aging Soc Policy, V18, P95, DOI 10.1300/J038v18n03_07
  • [10] How caregivers and workers fared in Cash and Counseling
    Foster, Leslie
    Dale, Stacy B.
    Brown, Randall
    [J]. HEALTH SERVICES RESEARCH, 2007, 42 (01) : 510 - 532