Impact of Dual Use of Medicare and Veterans Health Administration on Mortality
Author Information
Author(s): Wolinsky Fredric D, Miller Thomas R, An Hyonggin, Brezinski Paul R, Vaughn Thomas E, Rosenthal Gary E
Primary Institution: Center for Research in the Implementation of Innovative Strategies in Practice (CRIISP), University of Iowa
Hypothesis
Does dual use of Medicare and the Veterans Health Administration increase mortality risk among older male veterans?
Conclusion
Dual use of the VHA and Medicare systems is associated with an increased risk of death among older male veterans.
Supporting Evidence
- 11% of veterans were classified as dual users.
- 50.3% of the sample had died by the end of the study period.
- Dual users had a 56.1% increased relative risk of mortality compared to non-veterans.
Takeaway
Using both Medicare and Veterans Health Administration services can be risky for older veterans because it might lead to less coordinated care, which can increase the chance of dying.
Methodology
Data from the Survey of Assets and Health Dynamics among the Oldest Old (AHEAD) were linked to Medicare claims and the National Death Index, analyzing mortality risk associated with dual use.
Potential Biases
Potential selection bias due to exclusion of non-self-respondents and those without linked Medicare claims.
Limitations
The study could not perform condition-specific analyses, lacked VHA claims data, and did not measure continuity of care.
Participant Demographics
The sample consisted of older male veterans, with 54% being veterans and a mean age of 77 years.
Statistical Information
P-Value
p = 0.009
Confidence Interval
(1.120, 2.177)
Statistical Significance
p < 0.05
Digital Object Identifier (DOI)
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