Center for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, 1660 S. Columbian Way, HSR&D MS-152, Seattle, WA, 98108, USA.
Department of Health Services, University of Washington, Seattle, WA, USA.
Adm Policy Ment Health. 2019 Mar;46(2):145-153. doi: 10.1007/s10488-018-0900-z.
Older veterans can obtain care from the Veterans Affairs Health System (VA), Medicare or both. We examined whether their use of mental health care was impacted by capacity effects stemming from younger, uninsured veterans' enrolling in VA to satisfy the individual mandate within Massachusetts Health Reform (MHR). Using administrative data, we applied a difference-in-difference approach to compare pre-post changes in mental health use following MHR implementation. Findings indicated MHR was associated with increases in use through Medicare and the probability of dual VA-Medicare use. These results provide support for the possibility that limited capacity led to care seeking outside VA.
老年退伍军人可以从退伍军人事务部医疗系统（VA）、医疗保险或两者中获得医疗服务。我们研究了他们对心理健康护理的使用是否受到以下因素的影响：来自年轻、无保险的退伍军人的容量效应，这些退伍军人选择加入 VA 以满足马萨诸塞州医疗改革（MHR）中的个人授权。使用行政数据，我们采用差异中的差异方法来比较 MHR 实施前后心理健康使用的变化。研究结果表明，MHR 通过医疗保险与 VA-医疗保险双重使用的概率增加了使用量。这些结果为以下可能性提供了支持：有限的容量导致在 VA 之外寻求护理。
