Dual utilization of Medicare and VA outpatient care among Veterans with spinal cord injuries and disorders

The Journal of Spinal Cord Medicine, 2023 · DOI: 10.1080/10790268.2022.2027321 · Published: January 1, 2023

Simple Explanation

This study examines Veterans with spinal cord injuries and disorders (SCI/D) who use both Veterans Affairs (VA) and Medicare outpatient services. It identifies how many Veterans are 'dual users' and what factors might be associated with using both systems. The goal is to understand if using both VA and Medicare impacts the coordination and effectiveness of their healthcare.

Study Duration

Not specified

Participants

13,902 Veterans with SCI/D

Evidence Level

Retrospective, cross-sectional, observational study

Key Findings

1
Approximately 30% of Veterans with SCI/D are dual users of VA and Medicare outpatient services.
2
Veterans were less likely to be VA only users if they were older than 69 and if they had been injured for greater than ten years.
3
African American Veterans with SCI (compared to white) were more likely to be VA only users.

Research Summary

This study investigates the dual use of VA and Medicare outpatient services among Veterans with SCI/D, finding that a substantial portion (30%) are dual users. The study identifies factors such as age, injury duration, and race as predictors of healthcare system utilization patterns. The authors conclude that improved strategies for care coordination and health information sharing are crucial for this population.

Practical Implications

Improved Care Coordination

There is a need for better integration and communication between VA and Medicare healthcare providers to ensure seamless and comprehensive care for Veterans with SCI/D.

Targeted Interventions

Healthcare interventions should be tailored to specific subgroups of Veterans, considering factors such as age, race, and duration of injury, to optimize healthcare utilization and outcomes.

Policy Implications

Policies should be developed to facilitate health information exchange between VA and non-VA clinicians, reducing duplication of services and improving continuity of care.

Study Limitations

1
The analysis was limited to VA and Medicare claims data, potentially missing data from private insurance or the Veterans Choice Act.
2
The SCIDO database may not include all Veterans with SCI/D throughout the US and was missing data for some Veterans.
3
The study did not include Veterans with SCI/D that utilized only VA inpatient services during the study time period.

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