The Effect of Increased Travel Reimbursement Rates on Health Care Utilization in the VA

Autor/inn/en	Nelson, Richard E.; Hicken, Bret; West, Alan; Rupper, Randall
Titel	The Effect of Increased Travel Reimbursement Rates on Health Care Utilization in the VA
Quelle	In: Journal of Rural Health, 28 (2012) 2, S.192-201 (10 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0890-765X
DOI	10.1111/j.1748-0361.2011.00387.x
Schlagwörter	Travel; State Programs; Patients; Veterans; Costs; Public Policy; Medical Services; Eligibility; Regression (Statistics); Rural Areas; Comparative Analysis; Access to Health Care + Suchen Sie Ihr Suchwort? Travelling; Reisen; Reise; Regierungsprogramm; Patient; Kriegsteilnehmer; Veteran; Cost; Kosten; Öffentliche Ordnung; Arzt; Eignung; Regression; Regressionsanalyse; Rural area; Ländlicher Raum
Abstract	Purpose: The reimbursement rate that eligible veterans receive for travel to Department of Veterans Affairs (VA) facilities increased from 11 to 28.5 cents per mile on February 1, 2008. We examined the effect of this policy change on utilization of outpatient, inpatient, and pharmacy services, stratifying veterans based on distance from a VA facility. Methods: We compared health care utilization and costs on a sample of VA patients in the 10.5 months before the reimbursement rate increase and the 10.5 months after the reimbursement rate increase. Using a difference-in-difference technique, we ran multivariable logistic and count regressions for utilization and generalized linear models (GLM) for cost outcomes. Regressions were stratified based on urban and rural residence, as well as by distance thresholds. Findings: Our cohort contained 250,958 veterans, 76.7% (n = 192,559) of whom were eligible to receive a travel reimbursement. After the reimbursement rate increase, eligible veterans at all distances were 6.8% more likely to have an outpatient encounter and had 2.6% more outpatient encounters in the VA compared to those not eligible for the reimbursement (P less than 0.001). Similar results were found for prescription fills at all distances, but inpatient encounters remained generally unaffected. Conclusions: Our results suggest that this policy change was successful in increasing access to VA care for patients regardless of location of residence. (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10