Inequities in access to VA'S aid and attendance enhanced pension benefit to help Veterans pay for long-term care.
Inequities in access to VA'S aid and attendance enhanced pension benefit to help Veterans pay for long-term care.
复制标题
获得退伍军人管理局援助和出勤率方面的不平等提高了养老金福利，帮助退伍军人支付长期护理费用。
DOI：
10.1111/1475-6773.13636
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发表时间：
2021
影响因子：
3.4
通讯作者：
MAllen,Susan
中科院分区：
文献类型：
--
作者：
Thomas,KaliS;Corneau,Emily;HVanHoutven,Courtney;Cornell,Portia;Aron,David;MDosa,David;MAllen,Susan
目的研究与接受援助和出勤（A&A）相关的特征，这是一种增强的养老金福利，适用于在需要日常援助的基础上获得资格的退伍军人，在接受养老金的退伍军人中。数据来源2016 - 2017年与医疗保险索赔相关的国家VA行政数据的二级数据分析。研究设计观察性研究，研究社会人口学，医疗，以及与领取养老金的退伍军人中A&A的接收相关的医疗保健利用特征。主要调查结果2017年，9.7%的退伍军人领取养老金，新获得了A&A福利。黑人和西班牙裔养老金领取者接受A&A的概率比白色养老金领取者低4.6个百分点（95%CI =-0.051，-0.042）。领取养老金的已婚退伍军人接受A&A的概率高出4.4个百分点（95%CI = 0.039，0.048）。大多数援助需求指标（例如，家庭健康利用，痴呆症，中风）与接受A&A的概率显著较高相关，但有明显的例外：诊断为创伤后应激障碍的养老金领取者（边际效应=-0.029，95%CI =-0.037，-0.021）或参加医疗补助（边际效应=-0.053，95%CI =-0.057，-0.050）的患者接受A&A的概率较低。未调整和调整后的接收率A&A之间的退伍军人领取养老金VA medical center.ConclusionsThis研究确定了潜在的不公平现象，在接收的A&A增强养老金之间的一个样本的退伍军人领取养老金。增加退伍军人外展，提供者教育和VA办公室协调可以潜在地减少获得这种福利的不公平现象。
ObjectiveTo examine characteristics that are associated with receipt of Aid and Attendance (A&A), an enhanced pension benefit for Veterans who qualify on the basis of needing daily assistance, among Veterans who receive pensions.Data sourcesSecondary data analysis of 2016‐2017 national VA administrative data linked with Medicare claims.Study designObservational study examining sociodemographic, medical, and healthcare utilization characteristics associated with receipt of A&A among Veterans receiving pension.Principal findingsIn 2017, 9.7% of Veterans with pension newly received the A&A benefit. The probability of receiving A&A among black and Hispanic pensioners was 4.6 percentage points lower than for white pensioners (95%CI = −0.051, −0.042). Married Veterans receiving pension had a 4.4‐percentage point higher probability of receiving A&A (95%CI = 0.039, 0.048). Most indicators of need for assistance (eg, home health utilization, dementia, stroke) were associated with significantly higher probabilities of receiving A&A, with notable exceptions: pensioners with a diagnosis of Post‐Traumatic Stress Disorder (marginal effect = −0.029 95%CI = −0.037, −0.021) or enrolled in Medicaid (marginal effect = −0.053, 95%CI = −0.057, −0.050) had lower probabilities of receiving A&A. Unadjusted and adjusted rates of receiving A&A among Veterans receiving pension varied by VA medical center.ConclusionsThis study identified potential inequities in receipt of the A&A enhanced pension among a sample of Veterans receiving pension. Increased Veteran outreach, provider education, and VA office coordination can potentially reduce inequities in access to this benefit.