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

来源：

MEDICAL CARE RESEARCH AND REVIEW | 2019年 / 76卷 / 01期

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

页码：89 / 114

页数：26

共 31 条

[11] Government Accountability Office, 2014, VA HLTH CAR ACT NEED
[12] Nonparametric estimation of average treatment effects under exogeneity: A review
Imbens, GW
[J]. REVIEW OF ECONOMICS AND STATISTICS, 2004, 86 (01) : 4 - 29
[13] A note on the efficiency of sandwich covariance matrix estimation
Kauermann, G
Carroll, RJ
[J]. JOURNAL OF THE AMERICAN STATISTICAL ASSOCIATION, 2001, 96 (456) : 1387 - 1396
[14] LaPlante Mitchell P, 2007, J Aging Soc Policy, V19, P47, DOI 10.1300/J031v19n03_04
[15] Stratification and weighting via the propensity score in estimation of causal treatment effects: a comparative study
Lunceford, JK
Davidian, M
[J]. STATISTICS IN MEDICINE, 2004, 23 (19) : 2937 - 2960
[16] Estimating log models: to transform or not to transform?
Manning, WG
Mullahy, J
[J]. JOURNAL OF HEALTH ECONOMICS, 2001, 20 (04) : 461 - 494
[17] Older patients with serious mental illness - Sensitivity to distance barriers for outpatient care
McCarthy, JF
Blow, FC
[J]. MEDICAL CARE, 2004, 42 (11) : 1073 - 1080
[18] Miller Katherine M, 2015, N C Med J, V76, P320
[19] Allowing Spouses to Be Paid Personal Care Providers: Spouse Availability and Effects on Medicaid-Funded Service Use and Expenditures
Newcomer, Robert J.
Kang, Taewoon
Doty, Pamela
[J]. GERONTOLOGIST, 2012, 52 (04) : 517 - 530
[20] Phibbs CS., 2010, HERC's outpatient average cost dataset for VA care: fiscal year 2009 update. Guidebook

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