+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Differences Among States in Rural Veterans' Use of VHA and Non-VHA Hospitals



Differences Among States in Rural Veterans' Use of VHA and Non-VHA Hospitals



Journal of Rural Health 33(1): 32-40



To understand how vouchers for non-VHA care of VHA-enrolled veterans might affect rural enrollees, we determined how much enrollees use VHA and non-VHA inpatient care, and whether this use varies substantially between rural and urban residents depending on state of residence. For veterans listed in the 2007 VHA enrollment file as living in Arizona, Iowa, Louisiana, Tennessee, Florida, South Carolina, Pennsylvania, or New York, we merged 2004-2007 administrative discharge data for all VHA hospitalizations with all non-VHA hospitalizations listed in state health department or hospital association databases. Within states, rural and urban residents (RUCA-defined) were compared on VHA and non-VHA hospitalization rates, overall and for major diagnostic categories. Non-VHA hospital use was much greater than VHA use, though it also was more variable across states. In states with higher proportions of urban enrollees, use of non-VHA hospitals was lower for small or isolated rural town residents than urban residents; in the more rural states, it was greater. Rural enrollees also used VHA hospitals more than urban enrollees if they lived in the South, but they used VHA hospitals less in other states. Findings were consistent across principal diagnoses, except that in every state, rural veterans were hospitalized less often for mental disorders but more for respiratory diseases. Logistic regressions controlling several covariates consistently showed that very rural enrollees relied on VHA hospitals more than urban enrollees. Vouchers would likely increase non-VHA use more in states with greater rural populations. Vouchers for non-VHA inpatient care might have greater impact in rural states.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 057617970

Download citation: RISBibTeXText

PMID: 26449177

DOI: 10.1111/jrh.12152


Related references

Differences in length of stay in Veterans Health Administration and other United States hospitals: is the gap closing?. Medical Care 41(8): 882-894, 2003

Inefficiency differences between critical access hospitals and prospectively paid rural hospitals. Journal of Health Politics, Policy and Law 35(1): 95-126, 2010

Web-Based Patient Education in Orthopedics: Systematic Review. Journal of Medical Internet Research 20(4): E143, 2018

Geographic differences in the use of Veterans Administration hospitals. Social Science and Medicine 28(4): 347-354, 1989

An overview of distribution of births in United States hospitals in 2008 with implications for small volume perinatal units in rural hospitals. Journal of Obstetric, Gynecologic, and Neonatal Nursing 40(4): 432-439, 2011

Block placements in rural Veterans Administration hospitals: a consortium approach. Social Work in Health Care 3(3): 331-343, 1978

Rural residents who are hospitalized in rural and urban hospitals: United States, 2010. Nchs Data Brief 2015(159): 1-8, 2015

Is the rural safety net at risk? Analysis of charity care provided by rural hospitals in five states. Policy Analysis Brief. W Series 4(1): 1-4, 2002

Do older rural and urban veterans experience different rates of unplanned readmission to VA and non-VA hospitals?. Journal of Rural Health 25(1): 62-69, 2009

Association of Admission to Veterans Affairs Hospitals vs Non-Veterans Affairs Hospitals With Mortality and Readmission Rates Among Older Men Hospitalized With Acute Myocardial Infarction, Heart Failure, or Pneumonia. JAMA 315(6): 582-592, 2016

Prescribing conventional antipsychotics at two Veterans Administration hospitals: are there geographical differences?. Cns Spectrums 6(11): 894-896, 2004

Differences in rehabilitation services and outcomes among stroke patients cared for in veterans hospitals. Health Services Research 35(6): 1293-1318, 2001

Differences in patient characteristics between Veterans Administration and community hospitals. Implications for VA planning. Medical Care 25(11): 1099-1104, 1987

A comparison of quality of care indicators in urban acute care hospitals and rural critical access hospitals in the United States. International Journal for Quality in Health Care 19(3): 141-149, 2007

Patterns of sex and racial/ethnic differences in patient health care experiences in US Veterans Affairs hospitals. Medical Care 52(4): 328-335, 2014