当前位置： SCI文献检索 > JOURNAL OF GENERAL INTERNAL MEDICINE期刊下所有文献 > Dual Medicare and Veteran Health Administration use and ambulatory care sensitive hospitalizations.

Dual Medicare and Veteran Health Administration use and ambulatory care sensitive hospitalizations.

Abstract：

OBJECTIVE:The objective of the study is to examine the association between ambulatory care sensitive hospitalizations (ACSH) and dual Medicare/Veteran Health Administration use. PARTICIPANTS:A nationally representative sample of Medicare beneficiaries, who participated in the Medicare Current Beneficiary Survey (MCBS). DESIGN/MEASUREMENTS:Cross-sectional analyses (N = 44,988) of linked fee-for-service Medicare claims and survey data from multiple years of the MCBS (2001-2005). Any ACSH and specific types of ACSH were measured using the list of prevention quality indicators developed by the Agency for Healthcare Research and Quality. Among veterans, dual Medicare/VHA use was defined as having inpatient or outpatient visits paid by VHA and consisted of three categories: 1) predominant-VHA use; 2) some VHA use and no VHA use. Unadjusted group differences in any ACSH were tested using chi-square tests. Logistic regressions were used to analyze the association between dual Medicare/VHA use and ACSH after controlling for demographic, socio-economic status, health status, functional status, smoking status and obesity. All analyses accounted for the complex design of the MCBS. RESULTS:Among inpatient users, 10.1% had ACSH events for acute conditions and 15.8% for chronic conditions. Among all survey respondents, 5% had any ACSH event. Among predominant-VHA users the rate was 4.9% and among veterans with some VHA use it was 3.7%. In bivariate and multivariate analyses, dual Medicare/VHA use was not significantly associated with any ACSH. CONCLUSION:In a representative sample of Medicare beneficiaries, despite low income and health status, veterans with dual Medicare/VHA use were as likely as veterans without dual use to have any ACSH, perhaps due to expanded healthcare access and emphasis on primary care in the VHA system.

journal_name

J Gen Intern Med

journal_title

Journal of general internal medicine

authors

Ajmera M,Wilkins TL,Sambamoorthi U

doi

10.1007/s11606-011-1788-4

subject

Has Abstract

pub_date

2011-11-01 00:00:00

pages

669-75

eissn

0884-8734

issn

1525-1497

journal_volume

26 Suppl 2

pub_type

杂志文章

在线工具

Dual Medicare and Veteran Health Administration use and ambulatory care sensitive hospitalizations.