Yingzhe Yuan is a data analyst at the Partnered Evidence-Based Policy Resource Center at the Veterans Affairs (VA) Boston Healthcare System and a research assistant at the Boston University School of Public Health, both in Massachusetts.
Kali S. Thomas is a research health scientist in the Center of Innovation in Long-Term Services and Supports at the Providence VA Medical Center and an associate professor in the Center for Gerontology and Healthcare Research, Brown University School of Public Health, all in Providence, Rhode Island.
Health Aff (Millwood). 2019 Jun;38(6):1037-1045. doi: 10.1377/hlthaff.2019.00020.
The Veteran-Directed Care (VDC) program facilitates independent community living among adults with multiple chronic conditions and functional limitations. Family caregivers value the choice and flexibility afforded by VDC, but rigorous evidence to support its impact on health care costs and use is needed. We identified veterans enrolled in VDC in fiscal year 2017 and investigated differences in hospital admissions and costs after initial receipt of VDC services. We compared VDC service recipients to a matched comparison group of veterans receiving homemaker or home health aide, home respite, and adult day health care services and found similar decreases in hospital use and costs from before to after enrollment in the groups. Further investigation into trends of nursing home use, identification of veterans most likely to benefit from VDC, and relative costs of operating VDC versus other purchased care programs is needed, but our results suggest that VDC remains a valuable option for supporting veterans and caregivers.
退伍军人主导护理（VDC）计划促进了患有多种慢性疾病和功能限制的成年人在社区的独立生活。家庭护理人员非常重视 VDC 提供的选择和灵活性，但需要有严格的证据来支持其对医疗保健成本和使用的影响。我们在 2017 财年确定了参与 VDC 的退伍军人，并调查了在最初接受 VDC 服务后的住院人数和费用差异。我们将 VDC 服务接受者与接受家庭佣工或家庭保健助手、家庭暂托和成人日间保健服务的退伍军人匹配对照小组进行了比较，发现两组在登记前后的住院使用和费用都有类似的减少。需要进一步调查养老院使用的趋势，确定最有可能从 VDC 中受益的退伍军人，以及运营 VDC 与其他购买护理计划的相对成本，但我们的结果表明，VDC 仍然是支持退伍军人和护理人员的有价值的选择。
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