Differences in Practice Styles in VA and Medicare: Causes and Implications

退伍军人管理局和医疗保险实践风格的差异：原因和影响

• 批准号: 8398676
• 负责人: PAUL L. HEBERT
• 金额: --
• 依托单位: VA PUGET SOUND HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-11-01 至 2015-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8398676
• 关键词: Address; Area; Caring; Cohort Analysis; Congresses; Conscious; Consensus; Cross-Sectional Studies; Data; Enrollment; Expenditure; Exposure to; Fee-for-Service Plans; Foundations; Funding; Government; Grant; Growth; Health Care Costs; Health Services; Health Surveys; Healthcare; Healthcare Systems; Lead; Length of Stay; Longevity; Medical; Medical center; Medicare; Medicare claim; Medicare/Medicaid; Methodology; Outcome; Patient Care; Patients; Physicians; Policies; Policy Maker; Population Study; Price; Quality of Care; Quality of life; Regression Analysis; Research; Research Personnel; Resources; Respondent; Solutions; Statistical Models; Structure; Surveys; Testing; Time; Variant; Veterans; Visit; administrative database; base; beneficiary; cohort; cost; demographics; experience; geographic difference; longitudinal analysis; satisfaction; treatment as usual

DESCRIPTION (provided by applicant): Objectives: The objective of this study is to compare practice styles, and inter-facility variationin practice styles and costs of health care services, in VA and Medicare. Specific aims are: Aim1: To characterize differences in the style of care between Medicare-eligible Veterans treated at the VA and those receiving care in Fee-for-Service (FFS) Medicare. Aim2: To compare inter-facility variation in practice style in the VA to that observed for Medicare as a whole. Research Plan: The proposed study is a cohort analysis using retrospective patient data from VA administrative databases, Medicare claims, and existing surveys of VA and Medicare enrollees (Large Health Survey of Enrolled Veterans, and the VA Survey of Health Experiences of Patients). The study population consists of Medicare-eligible patients who responded to the Large Health Survey of Enrolled Veterans for Aim 1, and veteran respondents to the FY2009-11 VA Survey of Health Experiences of Patients (SHEP) for Aim 2. Methodology: Aim 1 is a longitudinal analysis of utilization within the VA and in Medicare for a cohort of Medicare eligibl Veterans. We use causal statistical models to estimate differences in the style of care provided by VA versus Medicare for these Veterans. Aim 2 is a cross sectional analysis using regression analysis to test the relationship between inter-facility variation in VA costs and utilization, controlling for patient demographics and comorbid conditions.

描述（由申请人提供）： 目的：本研究的目的是比较VA和Medicare的实践风格以及实践风格和医疗保健服务成本的机构间差异。具体目标是：目标1：描述在VA接受治疗的符合Medicare资格的退伍军人与在Fee-for-Service（FFS）Medicare接受治疗的退伍军人之间的护理风格差异。 目的2：比较VA中实践风格的设施间差异与整体医疗保险中观察到的差异。研究计划：拟议的研究是一项队列分析，使用来自VA管理数据库、医疗保险索赔以及VA和医疗保险登记者的现有调查（登记退伍军人的大型健康调查和VA患者健康经历调查）的回顾性患者数据。研究人群包括符合Medicare条件的患者，他们对入组退伍军人大型健康调查（Aim 1）做出了应答，对退伍军人2009 -11财年患者健康体验VA调查（SHEP）做出了应答（Aim 2）。方法：目的1是一个纵向分析的利用率内VA和医疗保险的医疗保险killbl退伍军人队列。我们使用因果统计模型来估计VA与Medicare为这些退伍军人提供的护理风格的差异。目标2是一项横断面分析，使用回归分析来测试VA成本和利用率的机构间差异之间的关系，控制患者人口统计学和共病状况。