BernheimV1, Main, Exploration, bibRecord, 000249

Use of Outpatient Care in Veterans Health Administration and Medicare among Veterans Receiving Primary Care in Community‐Based and Hospital Outpatient Clinics

Identifieur interne : 000249 ( Main/Exploration ); précédent : 000248; suivant : 000250

Use of Outpatient Care in Veterans Health Administration and Medicare among Veterans Receiving Primary Care in Community‐Based and Hospital Outpatient Clinics

Auteurs : Chuan-Fen Liu [États-Unis] ; Michael Chapko [États-Unis] ; Chris L. Bryson [États-Unis] ; James F. Burgess Jr. [États-Unis] ; John C. Fortney [États-Unis] ; Mark Perkins [États-Unis] ; Nancy D. Sharp [États-Unis] ; Matthew L. Maciejewski [États-Unis]

Source :

Health Services Research [ 0017-9124 ] ; 2010-10.

RBID : ISTEX:EA180490BD924A66A6BC2390D2F7954367531224

English descriptors

Teeft :
- Airr, Borowsky, Care visits, Chapko, Clinic, Cohort, Community clinic, Community clinics, Fortney, Health care, Health services research, Health services research part, Hospital outpatient clinics, Hospitalbased patients, Inpatient care, Little rock, Maciejewski, Medicaid, Medical care, Medicare, Medicare denominator, Medicare eligibility, Medicare percent, Medicare services, Mental health, Mental health care, Mental health services, Mental health visits, October, Older adults, Original reason, Outcomes research, Outpatient, Outpatient care, Outpatient clinics, Outpatient service, Outpatient services, Outpatient visits, Patient characteristics, Percent visits, Previous study, Primary care, Primary care patients, Primary care users, Primary care visits, Procedure codes, Provider, Sampling weights, Specialty, Specialty care, Specialty care visits, Study sample, Veterans affairs, Veterans health administration, Visit type.

Abstract

Objective. To examine differences in use of Veterans Health Administration (VA) and Medicare outpatient services by VA primary care patients.

Data Sources/Study Setting. VA administrative and Medicare claims data from 2001 to 2004.

Study Design. Retrospective cohort study of outpatient service use by 8,964 community‐based and 6,556 hospital‐based VA primary care patients.

Principal Findings. A significant proportion of VA patients used Medicare‐reimbursed primary care (>30 percent) and specialty care (>60 percent), but not mental health care (3–4 percent). Community‐based patients had 17 percent fewer VA primary care visits (p<.001), 9 percent more Medicare‐reimbursed visits (p<.001), and 6 percent fewer total visits (p<.05) than hospital‐based patients. Community‐based patients had 22 percent fewer VA specialty care visits (p<.0001) and 21 percent more Medicare‐reimbursed specialty care visits (p<.0001) than hospital‐based patients, but no difference in total visits (p=.80).

Conclusions. Medicare‐eligible VA primary care patients followed over 4 consecutive years used significant primary care and specialty care outside of VA. Community‐based patients offset decreased VA use with increased service use paid by Medicare, suggesting that increasing access to VA primary care via community clinics may fragment veteran care in unintended ways. Coordination of care between VA and non‐VA providers and health care systems is essential to improve the quality and continuity of care.

Url:

https://api.istex.fr/document/EA180490BD924A66A6BC2390D2F7954367531224/fulltext/pdf

DOI: 10.1111/j.1475-6773.2010.01123.x

Affiliations:

Links toward previous steps (curation, corpus...)

to stream Istex, to step Corpus: 000938
to stream Istex, to step Curation: 000937
to stream Istex, to step Checkpoint: 000058
to stream Main, to step Merge: 000252
to stream Main, to step Curation: 000249

Le document en format XML

<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Use of Outpatient Care in Veterans Health Administration and Medicare among Veterans Receiving Primary Care in Community‐Based and Hospital Outpatient Clinics</title>
<author><name sortKey="Liu, Chuan En" sort="Liu, Chuan En" uniqKey="Liu C" first="Chuan-Fen" last="Liu">Chuan-Fen Liu</name>
</author>
<author><name sortKey="Chapko, Michael" sort="Chapko, Michael" uniqKey="Chapko M" first="Michael" last="Chapko">Michael Chapko</name>
</author>
<author><name sortKey="Bryson, Chris L" sort="Bryson, Chris L" uniqKey="Bryson C" first="Chris L." last="Bryson">Chris L. Bryson</name>
</author>
<author><name sortKey="Burgess Jr, James F" sort="Burgess Jr, James F" uniqKey="Burgess Jr J" first="James F." last="Burgess Jr.">James F. Burgess Jr.</name>
</author>
<author><name sortKey="Fortney, John C" sort="Fortney, John C" uniqKey="Fortney J" first="John C." last="Fortney">John C. Fortney</name>
</author>
<author><name sortKey="Perkins, Mark" sort="Perkins, Mark" uniqKey="Perkins M" first="Mark" last="Perkins">Mark Perkins</name>
</author>
<author><name sortKey="Sharp, Nancy D" sort="Sharp, Nancy D" uniqKey="Sharp N" first="Nancy D." last="Sharp">Nancy D. Sharp</name>
</author>
<author><name sortKey="Maciejewski, Matthew L" sort="Maciejewski, Matthew L" uniqKey="Maciejewski M" first="Matthew L." last="Maciejewski">Matthew L. Maciejewski</name>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">ISTEX</idno>
<idno type="RBID">ISTEX:EA180490BD924A66A6BC2390D2F7954367531224</idno>
<date when="2010" year="2010">2010</date>
<idno type="doi">10.1111/j.1475-6773.2010.01123.x</idno>
<idno type="url">https://api.istex.fr/document/EA180490BD924A66A6BC2390D2F7954367531224/fulltext/pdf</idno>
<idno type="wicri:Area/Istex/Corpus">000938</idno>
<idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">000938</idno>
<idno type="wicri:Area/Istex/Curation">000937</idno>
<idno type="wicri:Area/Istex/Checkpoint">000058</idno>
<idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Checkpoint">000058</idno>
<idno type="wicri:doubleKey">0017-9124:2010:Liu C:use:of:outpatient</idno>
<idno type="wicri:Area/Main/Merge">000252</idno>
<idno type="wicri:Area/Main/Curation">000249</idno>
<idno type="wicri:Area/Main/Exploration">000249</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title level="a" type="main">Use of Outpatient Care in Veterans Health Administration and Medicare among Veterans Receiving Primary Care in Community‐Based and Hospital Outpatient Clinics</title>
<author><name sortKey="Liu, Chuan En" sort="Liu, Chuan En" uniqKey="Liu C" first="Chuan-Fen" last="Liu">Chuan-Fen Liu</name>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Washington (État)</region>
</placeName>
<wicri:cityArea>Northwest Center for Outcomes Research in Older Adults, Department of Veterans Affairs, HSR&D, VA Puget Sound Health Care System, 1100 Olive Way, Suite 1400, Seattle</wicri:cityArea>
</affiliation>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Washington (État)</region>
</placeName>
<wicri:cityArea>Department of Health Services, University of Washington, Seattle</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Chapko, Michael" sort="Chapko, Michael" uniqKey="Chapko M" first="Michael" last="Chapko">Michael Chapko</name>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Washington (État)</region>
</placeName>
<wicri:cityArea>Northwest Center for Outcomes Research in Older Adults, Department of Veterans Affairs, Seattle</wicri:cityArea>
</affiliation>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Washington (État)</region>
</placeName>
<wicri:cityArea>Department of Health Services, University of Washington, Seattle</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Bryson, Chris L" sort="Bryson, Chris L" uniqKey="Bryson C" first="Chris L." last="Bryson">Chris L. Bryson</name>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Washington (État)</region>
</placeName>
<wicri:cityArea>Northwest Center for Outcomes Research in Older Adults, Department of Veterans Affairs, Seattle</wicri:cityArea>
</affiliation>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Washington (État)</region>
</placeName>
<wicri:cityArea>Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Burgess Jr, James F" sort="Burgess Jr, James F" uniqKey="Burgess Jr J" first="James F." last="Burgess Jr.">James F. Burgess Jr.</name>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Massachusetts</region>
</placeName>
<wicri:cityArea>Center for Organization, Leadership & Management Research, Department of Veterans Affairs, Boston</wicri:cityArea>
</affiliation>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Massachusetts</region>
</placeName>
<wicri:cityArea>Department of Health Policy and Management, School of Public Health, Boston University, Boston</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Fortney, John C" sort="Fortney, John C" uniqKey="Fortney J" first="John C." last="Fortney">John C. Fortney</name>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Arkansas</region>
</placeName>
<wicri:cityArea>South Central Mental Health Illness Research and Education and Clinical Center, North Little Rock</wicri:cityArea>
</affiliation>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Arkansas</region>
</placeName>
<wicri:cityArea>HSR&D Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, North Little Rock</wicri:cityArea>
</affiliation>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Arkansas</region>
</placeName>
<wicri:cityArea>Division of Health Service Research, Department of Psychiatry and Behavioral Sciences, University of Arkansas for Medical Sciences, North Little Rock</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Perkins, Mark" sort="Perkins, Mark" uniqKey="Perkins M" first="Mark" last="Perkins">Mark Perkins</name>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Washington (État)</region>
</placeName>
<wicri:cityArea>Northwest Center for Outcomes Research in Older Adults, Department of Veterans Affairs, Seattle</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Sharp, Nancy D" sort="Sharp, Nancy D" uniqKey="Sharp N" first="Nancy D." last="Sharp">Nancy D. Sharp</name>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Washington (État)</region>
</placeName>
<wicri:cityArea>Northwest Center for Outcomes Research in Older Adults, Department of Veterans Affairs, Seattle</wicri:cityArea>
</affiliation>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Washington (État)</region>
</placeName>
<wicri:cityArea>Department of Health Services, University of Washington, Seattle</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Maciejewski, Matthew L" sort="Maciejewski, Matthew L" uniqKey="Maciejewski M" first="Matthew L." last="Maciejewski">Matthew L. Maciejewski</name>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Caroline du Nord</region>
</placeName>
<wicri:cityArea>Center for Health Services Research in Primary Care, Department of Veterans Affairs, Durham</wicri:cityArea>
</affiliation>
<affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Caroline du Nord</region>
</placeName>
<wicri:cityArea>Division of General Internal Medicine, Department of Medicine, Duke University Medical Center, Durham</wicri:cityArea>
</affiliation>
</author>
</analytic>
<monogr></monogr>
<series><title level="j" type="main">Health Services Research</title>
<title level="j" type="alt">HEALTH SERVICES RESEARCH</title>
<idno type="ISSN">0017-9124</idno>
<idno type="eISSN">1475-6773</idno>
<imprint><biblScope unit="vol">45</biblScope>
<biblScope unit="issue">5p1</biblScope>
<biblScope unit="page" from="1268">1268</biblScope>
<biblScope unit="page" to="1286">1286</biblScope>
<biblScope unit="page-count">19</biblScope>
<publisher>Blackwell Publishing Inc</publisher>
<pubPlace>Malden, USA</pubPlace>
<date type="published" when="2010-10">2010-10</date>
</imprint>
<idno type="ISSN">0017-9124</idno>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><idno type="ISSN">0017-9124</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Airr</term>
<term>Borowsky</term>
<term>Care visits</term>
<term>Chapko</term>
<term>Clinic</term>
<term>Cohort</term>
<term>Community clinic</term>
<term>Community clinics</term>
<term>Fortney</term>
<term>Health care</term>
<term>Health services research</term>
<term>Health services research part</term>
<term>Hospital outpatient clinics</term>
<term>Hospitalbased patients</term>
<term>Inpatient care</term>
<term>Little rock</term>
<term>Maciejewski</term>
<term>Medicaid</term>
<term>Medical care</term>
<term>Medicare</term>
<term>Medicare denominator</term>
<term>Medicare eligibility</term>
<term>Medicare percent</term>
<term>Medicare services</term>
<term>Mental health</term>
<term>Mental health care</term>
<term>Mental health services</term>
<term>Mental health visits</term>
<term>October</term>
<term>Older adults</term>
<term>Original reason</term>
<term>Outcomes research</term>
<term>Outpatient</term>
<term>Outpatient care</term>
<term>Outpatient clinics</term>
<term>Outpatient service</term>
<term>Outpatient services</term>
<term>Outpatient visits</term>
<term>Patient characteristics</term>
<term>Percent visits</term>
<term>Previous study</term>
<term>Primary care</term>
<term>Primary care patients</term>
<term>Primary care users</term>
<term>Primary care visits</term>
<term>Procedure codes</term>
<term>Provider</term>
<term>Sampling weights</term>
<term>Specialty</term>
<term>Specialty care</term>
<term>Specialty care visits</term>
<term>Study sample</term>
<term>Veterans affairs</term>
<term>Veterans health administration</term>
<term>Visit type</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract">Objective. To examine differences in use of Veterans Health Administration (VA) and Medicare outpatient services by VA primary care patients.</div>
<div type="abstract">Data Sources/Study Setting. VA administrative and Medicare claims data from 2001 to 2004.</div>
<div type="abstract">Study Design. Retrospective cohort study of outpatient service use by 8,964 community‐based and 6,556 hospital‐based VA primary care patients.</div>
<div type="abstract">Principal Findings. A significant proportion of VA patients used Medicare‐reimbursed primary care (>30 percent) and specialty care (>60 percent), but not mental health care (3–4 percent). Community‐based patients had 17 percent fewer VA primary care visits (p<.001), 9 percent more Medicare‐reimbursed visits (p<.001), and 6 percent fewer total visits (p<.05) than hospital‐based patients. Community‐based patients had 22 percent fewer VA specialty care visits (p<.0001) and 21 percent more Medicare‐reimbursed specialty care visits (p<.0001) than hospital‐based patients, but no difference in total visits (p=.80).</div>
<div type="abstract">Conclusions. Medicare‐eligible VA primary care patients followed over 4 consecutive years used significant primary care and specialty care outside of VA. Community‐based patients offset decreased VA use with increased service use paid by Medicare, suggesting that increasing access to VA primary care via community clinics may fragment veteran care in unintended ways. Coordination of care between VA and non‐VA providers and health care systems is essential to improve the quality and continuity of care.</div>
</front>
</TEI>
<affiliations><list><country><li>États-Unis</li>
</country>
<region><li>Arkansas</li>
<li>Caroline du Nord</li>
<li>Massachusetts</li>
<li>Washington (État)</li>
</region>
</list>
<tree><country name="États-Unis"><region name="Washington (État)"><name sortKey="Liu, Chuan En" sort="Liu, Chuan En" uniqKey="Liu C" first="Chuan-Fen" last="Liu">Chuan-Fen Liu</name>
</region>
<name sortKey="Bryson, Chris L" sort="Bryson, Chris L" uniqKey="Bryson C" first="Chris L." last="Bryson">Chris L. Bryson</name>
<name sortKey="Bryson, Chris L" sort="Bryson, Chris L" uniqKey="Bryson C" first="Chris L." last="Bryson">Chris L. Bryson</name>
<name sortKey="Burgess Jr, James F" sort="Burgess Jr, James F" uniqKey="Burgess Jr J" first="James F." last="Burgess Jr.">James F. Burgess Jr.</name>
<name sortKey="Burgess Jr, James F" sort="Burgess Jr, James F" uniqKey="Burgess Jr J" first="James F." last="Burgess Jr.">James F. Burgess Jr.</name>
<name sortKey="Chapko, Michael" sort="Chapko, Michael" uniqKey="Chapko M" first="Michael" last="Chapko">Michael Chapko</name>
<name sortKey="Chapko, Michael" sort="Chapko, Michael" uniqKey="Chapko M" first="Michael" last="Chapko">Michael Chapko</name>
<name sortKey="Fortney, John C" sort="Fortney, John C" uniqKey="Fortney J" first="John C." last="Fortney">John C. Fortney</name>
<name sortKey="Fortney, John C" sort="Fortney, John C" uniqKey="Fortney J" first="John C." last="Fortney">John C. Fortney</name>
<name sortKey="Fortney, John C" sort="Fortney, John C" uniqKey="Fortney J" first="John C." last="Fortney">John C. Fortney</name>
<name sortKey="Liu, Chuan En" sort="Liu, Chuan En" uniqKey="Liu C" first="Chuan-Fen" last="Liu">Chuan-Fen Liu</name>
<name sortKey="Maciejewski, Matthew L" sort="Maciejewski, Matthew L" uniqKey="Maciejewski M" first="Matthew L." last="Maciejewski">Matthew L. Maciejewski</name>
<name sortKey="Maciejewski, Matthew L" sort="Maciejewski, Matthew L" uniqKey="Maciejewski M" first="Matthew L." last="Maciejewski">Matthew L. Maciejewski</name>
<name sortKey="Perkins, Mark" sort="Perkins, Mark" uniqKey="Perkins M" first="Mark" last="Perkins">Mark Perkins</name>
<name sortKey="Sharp, Nancy D" sort="Sharp, Nancy D" uniqKey="Sharp N" first="Nancy D." last="Sharp">Nancy D. Sharp</name>
<name sortKey="Sharp, Nancy D" sort="Sharp, Nancy D" uniqKey="Sharp N" first="Nancy D." last="Sharp">Nancy D. Sharp</name>
</country>
</tree>
</affiliations>
</record>

Pour manipuler ce document sous Unix (Dilib)

EXPLOR_STEP=$WICRI_ROOT/Wicri/Psychologie/explor/BernheimV1/Data/Main/Exploration

HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000249 | SxmlIndent | more

HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 000249 | SxmlIndent | more

Pour mettre un lien sur cette page dans le réseau Wicri

{{Explor lien
   |wiki=    Wicri/Psychologie
   |area=    BernheimV1
   |flux=    Main
   |étape=   Exploration
   |type=    RBID
   |clé=     ISTEX:EA180490BD924A66A6BC2390D2F7954367531224
   |texte=   Use of Outpatient Care in Veterans Health Administration and Medicare among Veterans Receiving Primary Care in Community‐Based and Hospital Outpatient Clinics
}}

This area was generated with Dilib version V0.6.33.
Data generation: Mon Mar 5 17:33:33 2018. Site generation: Thu Apr 29 15:49:51 2021

	Serveur d'exploration Hippolyte Bernheim
	Attention, ce site est en cours de développement ! Attention, site généré par des moyens informatiques à partir de corpus bruts. Les informations ne sont donc pas validées.

Serveur d'exploration Hippolyte Bernheim

Use of Outpatient Care in Veterans Health Administration and Medicare among Veterans Receiving Primary Care in Community‐Based and Hospital Outpatient Clinics

Use of Outpatient Care in Veterans Health Administration and Medicare among Veterans Receiving Primary Care in Community‐Based and Hospital Outpatient Clinics

Source :

English descriptors

Abstract

Links toward previous steps (curation, corpus...)

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri