A random effects multinomial logit analysis of using Medicare and VA healthcare among veterans with dementia.

Home Health Care Services Quarterly
Carolyn W ZhuJoan D Penrod

Abstract

This study aimed to examine longitudinal patterns of VA-only use, dual VA and Medicare use, or Medicare-only use among veterans with dementia. Data on VA and Medicare use (1998-2001) were obtained from VA administrative datasets and Medicare claims for 2,137 male veterans with a formal diagnosis of Alzheimer's disease or vascular dementia enrolled in the National Longitudinal Caregiver Study. A random effects multinomial logit model accounting for unobserved individual heterogeneity was used to estimate the effects of patient and caregiver characteristics on use group over time. Compared to VA-only use, dual VA and Medicare use was associated with being white, married, higher education, having private insurance, Medicaid, low VA priority level, more functional limitations, and having lived in a nursing home or died in that year. Medicare-only use was associated with older age, being married, higher education, having private insurance, low VA priority level, living further from a VA Medical Center, having more comorbidities, functional limitations, and having lived in a nursing home or died. Veterans whose caregivers reported better health were more likely to be dual users, but those whose caregivers reported more comorbidities ...Continue Reading

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Citations

Aug 21, 2012·Journal of Community Health·Preethy NayarPeter Woodbridge
Dec 19, 2013·Tropical Animal Health and Production·Jonathan MockshellRegina Birner
Jan 1, 2012·Medicare & Medicaid Research Review·Jennifer HumenskyDenise M Hynes
Sep 30, 2015·BMC Health Services Research·Alan N WestMary Vaughan-Sarrazin
Aug 3, 2016·The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association·Alan N West, Mary E Charlton
Jan 1, 2012·Journal of Primary Care & Community Health·Peter J KaboliMary E Charlton
Apr 3, 2014·Archives of Trauma Research·Rajiv SinghSarah Bruce
Aug 14, 2019·Journal of the American Geriatrics Society·Tyler KentKelly J Ko

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