Veterans Using Home Healthcare have Higher Rates of Outpatient, Inpatient, and Nursing Home Care

Since 2000, the number of veterans using VA services for long-term care (LTC) increased by nearly 25%, with a shift from institutional LTC to less expensive community-based care such as home health care (HHC). Thus, the VA healthcare system is in the process of significantly expanding HHC nationwide. This case-controlled study sought to describe individual and organization characteristics associated with using HHC, as well as HHC use across a broad spectrum of healthcare services. Using VA data, investigators identified the full cohort of male veterans using HHC (n=24,169) in 2002, as well as a sample of non-HHC users (n=53,356). Use of healthcare services was measured for 2003 and included VA and Medicare outpatient, inpatient, nursing home, and hospice use, in addition to VA home-based primary care, respite care, and adult day health care. Findings show that veterans receiving VA home health care in 2002 increased their absolute chance of using VA outpatient care by 3%, inpatient care by nearly 12%, and nursing home care by 5% in 2003. Moreover, although utilization rates were low, VA HHC users were about 10 times more likely to have used hospice, adult day health care, or respite care in the VA system than non-users.

Van Houtven C, Jeffreys A, and Coffman C. Home health care and patterns of subsequent VA and Medicare health care utilization for veterans. The Gerontologist 2008 October;48(5):668-78.

Dr. Van Houtven is part of HSR&D’s Center for Health Services Research in Primary Care, Durham, NC.