Access to Care

Dual Veterans Administration/Medicare users are not hospitalized more for ambulatory care sensitive conditions

Dual-use veterans, i.e., those obtaining care from both Medicare and the Veteran Health Administration (VHA), have the potential for redundant care, health information loss, and fragmented care. Since there was some evidence from prior studies that dual-use veterans have higher morbidity and mortality, a research team decided to investigate the issue by looking at the relationship between ambulatory care sensitive hospitalizations (ACSHs) and dual use among veterans.

ACSH conditions are those for which good outpatient care can prevent hospitalizations. Despite having poor socioeconomic characteristics, health status, and other health risk factors, dual VHA/Medicare users were no more likely than veterans with no VHA use to have any ACSHs, found the researchers. ACSH conditions include congestive heart failure, bacterial pneumonia, and chronic obstructive pulmonary disease.

The study's findings suggest that dual VHA/Medicare users could be using both systems to have enhanced access in order to better manage their conditions. Data for the study came from the annual Medicare Current Beneficiary Surveys, a nationally representative sample of aged, disabled, and institutionalized Medicare beneficiaries. This study was supported in part by the Agency for Healthcare Research and Quality (HS18622).

See "Dual Medicare and Veteran Health Administration use and ambulatory care sensitive hospitalizations" by Mayank Ajmera, B.Pharm., M.S., Tricia Lee Wilkins, Pharm.D., and Usha Sambamoorthi, Ph.D., in the Journal of General Internal Medicine 26(Suppl 2), pp. 669-675, 2011.