对家庭照顾者的全面支持：对退伍军人医疗保健利用和成本的影响。
Comprehensive Support for Family Caregivers: Impact on Veteran Health Care Utilization and Costs.
作者信息
Van Houtven Courtney Harold, Smith Valerie A, Stechuchak Karen M, Shepherd-Banigan Megan, Hastings Susan Nicole, Maciejewski Matthew L, Wieland Gilbert Darryl, Olsen Maren K, Miller Katherine E M, Kabat Margaret, Henius Jennifer, Campbell-Kotler Margaret, Oddone Eugene Z
机构信息
1 Durham VA Medical Center, Durham, NC, USA.
2 Duke University Medical Center, Durham, NC, USA.
出版信息
Med Care Res Rev. 2019 Feb;76(1):89-114. doi: 10.1177/1077558717697015. Epub 2017 Apr 1.
This study aimed to examine the early impact of the Program of Comprehensive Assistance for Family Caregivers (PCAFC) on Veteran health care utilization and costs. A pre-post cohort design including a nonequivalent control group was used to understand how Veterans' use of Veteran Affairs health care and total health care costs changed in 6-month intervals up to 3 years after PCAFC enrollment. The control group was an inverse probability of treatment weighted sample of Veterans whose caregivers applied for, but were not accepted into, PCAFC. Veterans in PCAFC had similar acute care utilization postenrollment when compared with those in the control group, but significantly greater primary, specialty, and mental health outpatient care use at least 30, and up to 36, months postenrollment. Estimated total health care costs for PCAFC Veterans were $1,500 to $3,400 higher per 6-month interval than for control group Veterans. PCAFC may have increased Veterans' access to care.
本研究旨在探讨家庭照顾者综合援助计划（PCAFC）对退伍军人医疗保健利用和成本的早期影响。采用包括非等效对照组的前后队列设计，以了解退伍军人在加入PCAFC后长达3年的时间里，每6个月间隔使用退伍军人事务部医疗保健的情况以及总医疗保健成本如何变化。对照组是照顾者申请但未被PCAFC录取的退伍军人的治疗加权逆概率样本。与对照组相比，加入PCAFC的退伍军人在入组后的急性护理利用率相似，但在入组后至少30个月至36个月期间，初级、专科和心理健康门诊护理的使用显著增加。PCAFC退伍军人每6个月间隔的估计总医疗保健成本比对照组退伍军人高1500美元至3400美元。PCAFC可能增加了退伍军人获得医疗服务的机会。
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