VA and Medicare Utilization Among Dually Enrolled Veterans with Type 2 Diabetes: A Latent Class Analysis

Journal of General Internal Medicine
Thomas R RadomskiWalid Gellad

Abstract

Many Veterans treated within the VA Healthcare System (VA) are also enrolled in fee-for-service (FFS) Medicare and receive treatment outside the VA. Prior research has not accounted for the multiple ways that Veterans receive services across healthcare systems. We aimed to establish a typology of VA and Medicare utilization among dually enrolled Veterans with type 2 diabetes. This was a retrospective cohort. 316,775 community-dwelling Veterans age ≥ 65 years with type 2 diabetes who were dually enrolled in the VA and FFS Medicare in 2008-2009. Using latent class analysis, we identified classes of Veterans based upon their probability of using VA and Medicare diabetes care services, including patient visits, laboratory tests, glucose test strips, and medications. We compared the amount of healthcare use between classes and identified factors associated with class membership using multinomial regression. We identified four distinct latent classes: class 1 (53.9%) had high probabilities of VA use and low probabilities of Medicare use; classes 2 (17.2%), 3 (21.8%), and 4 (7.0%) had high probabilities of VA and Medicare use, but differed in their Medicare services used. For example, Veterans in class 3 received test strips exclusive...Continue Reading

References

Nov 1, 1994·Journal of Clinical Epidemiology·M CharlsonJ Gold
Jul 16, 2005·American Journal of Medical Quality : the Official Journal of the American College of Medical Quality·Amy K RosenAnn Hendricks
Jul 25, 2006·Medical Care·Margaret M ByrneLaura A Petersen
Oct 13, 2006·BMC Health Services Research·Fredric D WolinskyGary E Rosenthal
Dec 30, 2006·Stroke; a Journal of Cerebral Circulation·Huanguang JiaPamela W Duncan
Feb 17, 2007·Medical Care·Denise M HynesLinda Kok
Mar 16, 2007·The New England Journal of Medicine·Hoangmai H PhamPeter B Bach
Mar 22, 2008·Health Services Research·Kathleen CareySusan L Ettner
Apr 5, 2008·Medical Care·Joseph S RossAlbert L Siu
Jun 21, 2008·Journal of Rehabilitation Research and Development·Yujing ShenThomas W Findley
Dec 23, 2008·Journal of General Internal Medicine·Chuan-Fen LiuEdmund F Chaney
Aug 18, 2009·Journal of the American Geriatrics Society·Carolyn W ZhuMary Sano
Nov 7, 2009·General Hospital Psychiatry·Anouk L GrubaughB Christopher Frueh
Aug 10, 2010·Patient Preference and Adherence·Ranak B TrivediHayden B Bosworth
May 28, 2011·Medical Care·Carolyn T ThorpeMaureen A Smith
Aug 5, 2011·BMC Health Services Research·Joshua M ThorpeNancy Pandhi
Oct 19, 2011·Journal of General Internal Medicine·Mayank AjmeraUsha Sambamoorthi
Oct 19, 2011·Policy, Politics & Nursing Practice·Denise K ThompsonMary-Rose Mueller
Feb 24, 2012·JAMA : the Journal of the American Medical Association·Kenneth W Kizer
Jun 28, 2012·JAMA : the Journal of the American Medical Association·Amal N TrivediKenneth W Kizer
Oct 10, 2012·Archives of Internal Medicine·Walid GelladChester Good
Oct 16, 2012·Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology·Elizabeth TarlovDenise M Hynes
Jan 19, 2013·BMC Health Services Research·Virginia WangMorris Weinberger
Jan 1, 2012·Medicare & Medicaid Research Review·Jennifer HumenskyDenise M Hynes
Jun 25, 2015·Academic Medicine : Journal of the Association of American Medical Colleges·Barbara K Chang, Judy L Brannen
Aug 21, 2015·Journal of General Internal Medicine·Walid F Gellad
Sep 19, 2015·Healthcare : the Journal of Delivery Science and Innovation·Austin B FraktSteven D Pizer

❮ Previous
Next ❯

Citations

Jun 14, 2018·Health Services Research·Mary Vaughan SarrazinCarolyn L Turvey
Apr 30, 2019·Healthcare : the Journal of Delivery Science and Innovation·Thomas R RadomskiWalid F Gellad
Feb 20, 2021·Clinical Journal of the American Society of Nephrology : CJASN·Winn CashionSteven D Weisbord
May 29, 2021·Journal of General Internal Medicine·Lianlian LeiDonovan T Maust

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.