Study Examines Predictors of OEF/OIF Army Active Duty Members' Linkage to VA Healthcare Post-Deployment
BACKGROUND:
In addition to medical care received when deployed, active duty service members may receive healthcare services at on-base military treatment facilities, the DoD Military Health System, or from private or VA providers. Active duty combat Veterans who served after November 1998 also are eligible to receive cost-free VA healthcare for five years after separation from the Army. This study sought to describe the rates and predictors of linkage to VA healthcare in the first 365 days after separation for 151,122 Army Active Duty members who served in Iraq and/or Afghanistan from FY08 through FY11. The main outcome variable was receipt of any outpatient, inpatient, or residential health care from any of 158 VA facilities. Using both VA and DoD data, predictor variables included: various demographic (i.e., age), deployment (i.e., length of index deployment), and separation characteristics (i.e., for disability, expiration of service). Investigators also used VA data to examine healthcare predictors, such as drive time to the nearest VA facility, receiving pre-separation VA services as either an enrollee in VA healthcare or a non-enrollee, and receiving post-separation VA services as a non-enrollee.
FINDINGS:
- Within 12 months of separation, 48% of OEF/OIF Army Active Duty members used VA healthcare.
- There was significant variation in linkage to care rates by VA healthcare facility: between 31% and 72% of Active Duty members assigned to a facility's catchment area used at least one VA healthcare service.
- The most notable variables associated with greater linkage to VA healthcare included probable serious injury during index deployment, separation due to disability, and receipt of VA care before or after military separation as a VA enrollee or non-enrollee.
- When compared with junior enlisted Army members, higher-ranking service members had considerably lower odds of seeking VA healthcare.
LIMITATIONS:
- Some Veterans seek and receive services (e.g., counseling) at VA Vet Centers, which are not included in VA administrative data.
- Only indirect measures of medical need were included in this study; more nuanced measures, such as service-connected disability rating, could be important.
IMPLICATIONS:
- Information about individual characteristics that predict greater or lesser linkage to VA healthcare services can be used to improve delivery of VA care, as well as outreach efforts to Active Duty service members.
AUTHOR/FUNDING INFORMATION:
Drs. Vanneman, Sox-Harris, and Ms. Chen are part of HSR&D's Center for Innovation to Implementation in Palo Alto, CA. Dr. Vanneman is a post-doctoral fellow in health services research, who is supported by the VA Office of Academic Affiliations. Dr. Sox-Harris is supported by an HSR&D Research Career Scientist Award.
Vanneman M, Harris A, Chen C, et al. Army Active Duty Members’ Linkage to Veterans Health Administration Services after Deployments to Iraq or Afghanistan and Following Separation. Military Medicine. October 2015;180(10):1052-58.
