Effect of the Affordable Care Act on healthcare utilization for Veterans with spinal cord injuries and disorders
Context/Objective: Provisions of the Affordable Care Act (ACA) potentially increase insurance options for Veterans with disabilities. We examined Veterans with spinal cord injuries and disorders (SCI/D) to assess whether the ACA was associated with changes in healthcare utilization from Department o...
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| Veröffentlicht in: | The journal of spinal cord medicine 2022-07, Vol.45 (4), p.575-584 |
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| container_title | The journal of spinal cord medicine |
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| creator | Martinez, Rachael N. Smith, Bridget M. French, Dustin D. Hogan, Timothy P. Gonzalez, Beverly Osteen, Chad M. Hatch, Maya Anderson, Vicki Tarlov, Elizabeth Silva, Abigail Goldstein, Barry Stroupe, Kevin T. |
| description | Context/Objective: Provisions of the Affordable Care Act (ACA) potentially increase insurance options for Veterans with disabilities. We examined Veterans with spinal cord injuries and disorders (SCI/D) to assess whether the ACA was associated with changes in healthcare utilization from Department of Veterans Affairs (VA) healthcare facilities.
Design: Using national VA data, we investigated impacts on VA healthcare utilization pre- (2012/13) and post-ACA (2014/15) implementation with negative binomial regression models.
Setting: VA healthcare facilities.
Participants: 8,591 VA users with SCI/D. Veterans with acute myelitis, Guillain-Barré syndrome, multiple sclerosis, or amyotrophic lateral sclerosis were excluded as were patients who died during the study period.
Interventions: We assessed VA healthcare utilization before and after ACA implementation.
Outcome Measures: Total numbers of VA visits for SCI/D care, diagnostic care, primary care, specialty care, and mental health care, and VA admissions.
Results: The number of VA admissions was 7% higher in the post than pre-ACA implementation period (P |
| doi_str_mv | 10.1080/10790268.2020.1829419 |
| format | Article |
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Design: Using national VA data, we investigated impacts on VA healthcare utilization pre- (2012/13) and post-ACA (2014/15) implementation with negative binomial regression models.
Setting: VA healthcare facilities.
Participants: 8,591 VA users with SCI/D. Veterans with acute myelitis, Guillain-Barré syndrome, multiple sclerosis, or amyotrophic lateral sclerosis were excluded as were patients who died during the study period.
Interventions: We assessed VA healthcare utilization before and after ACA implementation.
Outcome Measures: Total numbers of VA visits for SCI/D care, diagnostic care, primary care, specialty care, and mental health care, and VA admissions.
Results: The number of VA admissions was 7% higher in the post than pre-ACA implementation period (P < 0.01). The number of VA visits post-implementation increased for SCI/D care (8%; P < 0.01) and specialty care (12%; P < 0.001). Conversely, the number of mental health visits was 17% lower in the post-ACA period (P < 0.001). Veterans with SCI/D who live <5 miles from their nearest VA facility received VA care more frequently than those ≥40 miles from VA (P < 0.001).
Conclusion: Counter to expectations, results suggest that Veterans with SCI/D sought more frequent VA care after ACA implementation, indicating Veterans with SCI/D continue to utilize the lifelong, comprehensive care provided at VA.]]></description><identifier>ISSN: 1079-0268</identifier><identifier>EISSN: 2045-7723</identifier><identifier>DOI: 10.1080/10790268.2020.1829419</identifier><identifier>PMID: 33085584</identifier><language>eng</language><publisher>England: Taylor & Francis</publisher><subject>Affordable Care Act ; Health policy ; Insurance ; Spinal cord injuries and disorders (SCI/D) ; Veterans Affairs</subject><ispartof>The journal of spinal cord medicine, 2022-07, Vol.45 (4), p.575-584</ispartof><rights>The Academy of Spinal Cord Injury Professionals, Inc. 2020 2020</rights><rights>The Academy of Spinal Cord Injury Professionals, Inc. 2020 2020 The Academy of Spinal Cord Injury Professionals, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c416t-cd65338488550392c21122161a360807aa0720b9698c322c950704bac78ca8173</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9246208/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9246208/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33085584$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Martinez, Rachael N.</creatorcontrib><creatorcontrib>Smith, Bridget M.</creatorcontrib><creatorcontrib>French, Dustin D.</creatorcontrib><creatorcontrib>Hogan, Timothy P.</creatorcontrib><creatorcontrib>Gonzalez, Beverly</creatorcontrib><creatorcontrib>Osteen, Chad M.</creatorcontrib><creatorcontrib>Hatch, Maya</creatorcontrib><creatorcontrib>Anderson, Vicki</creatorcontrib><creatorcontrib>Tarlov, Elizabeth</creatorcontrib><creatorcontrib>Silva, Abigail</creatorcontrib><creatorcontrib>Goldstein, Barry</creatorcontrib><creatorcontrib>Stroupe, Kevin T.</creatorcontrib><title>Effect of the Affordable Care Act on healthcare utilization for Veterans with spinal cord injuries and disorders</title><title>The journal of spinal cord medicine</title><addtitle>J Spinal Cord Med</addtitle><description><![CDATA[Context/Objective: Provisions of the Affordable Care Act (ACA) potentially increase insurance options for Veterans with disabilities. We examined Veterans with spinal cord injuries and disorders (SCI/D) to assess whether the ACA was associated with changes in healthcare utilization from Department of Veterans Affairs (VA) healthcare facilities.
Design: Using national VA data, we investigated impacts on VA healthcare utilization pre- (2012/13) and post-ACA (2014/15) implementation with negative binomial regression models.
Setting: VA healthcare facilities.
Participants: 8,591 VA users with SCI/D. Veterans with acute myelitis, Guillain-Barré syndrome, multiple sclerosis, or amyotrophic lateral sclerosis were excluded as were patients who died during the study period.
Interventions: We assessed VA healthcare utilization before and after ACA implementation.
Outcome Measures: Total numbers of VA visits for SCI/D care, diagnostic care, primary care, specialty care, and mental health care, and VA admissions.
Results: The number of VA admissions was 7% higher in the post than pre-ACA implementation period (P < 0.01). The number of VA visits post-implementation increased for SCI/D care (8%; P < 0.01) and specialty care (12%; P < 0.001). Conversely, the number of mental health visits was 17% lower in the post-ACA period (P < 0.001). Veterans with SCI/D who live <5 miles from their nearest VA facility received VA care more frequently than those ≥40 miles from VA (P < 0.001).
Conclusion: Counter to expectations, results suggest that Veterans with SCI/D sought more frequent VA care after ACA implementation, indicating Veterans with SCI/D continue to utilize the lifelong, comprehensive care provided at VA.]]></description><subject>Affordable Care Act</subject><subject>Health policy</subject><subject>Insurance</subject><subject>Spinal cord injuries and disorders (SCI/D)</subject><subject>Veterans Affairs</subject><issn>1079-0268</issn><issn>2045-7723</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kU9v3CAQxVGVqtkm_QiJOObilD82hkvVaJW0lSL10uaKZjGuiVjYAk6UfPpi7SZqLz0h3vx4M8xD6IySS0ok-UhJrwgT8pIRViXJVEvVG7RipO2avmf8CK0WplmgY_Q-53tCOqU4f4eOOSey62S7QrvrcbSm4DjiMll8NY4xDbDxFq8h1ftSCniy4MtkFmUuzrtnKK7KlcV3ttgEIeNHVyacdy6Ax6aaYBfu5-RsxhAGPLhcNZvyKXo7gs_2w-E8QT9vrn-svza33798W1_dNqalojRmEB3nspV1TsIVM4xSxqigwEX9fg9AekY2SihpOGNGdaQn7QZMLw1I2vMT9Gnvu5s3WzsYG0oCr3fJbSE96QhO_1sJbtK_4oNWrBWMyGpwcTBI8fdsc9Fbl431HoKNc9as7bio4wlV0W6PmhRzTnZ8bUOJXtLSL2npJS19SKu-O_97xtdXL_FU4PMecKHueguPMflBF3jyMY1168Zlzf_f4w-yQKRl</recordid><startdate>20220704</startdate><enddate>20220704</enddate><creator>Martinez, Rachael N.</creator><creator>Smith, Bridget M.</creator><creator>French, Dustin D.</creator><creator>Hogan, Timothy P.</creator><creator>Gonzalez, Beverly</creator><creator>Osteen, Chad M.</creator><creator>Hatch, Maya</creator><creator>Anderson, Vicki</creator><creator>Tarlov, Elizabeth</creator><creator>Silva, Abigail</creator><creator>Goldstein, Barry</creator><creator>Stroupe, Kevin T.</creator><general>Taylor & Francis</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20220704</creationdate><title>Effect of the Affordable Care Act on healthcare utilization for Veterans with spinal cord injuries and disorders</title><author>Martinez, Rachael N. ; Smith, Bridget M. ; French, Dustin D. ; Hogan, Timothy P. ; Gonzalez, Beverly ; Osteen, Chad M. ; Hatch, Maya ; Anderson, Vicki ; Tarlov, Elizabeth ; Silva, Abigail ; Goldstein, Barry ; Stroupe, Kevin T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c416t-cd65338488550392c21122161a360807aa0720b9698c322c950704bac78ca8173</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Affordable Care Act</topic><topic>Health policy</topic><topic>Insurance</topic><topic>Spinal cord injuries and disorders (SCI/D)</topic><topic>Veterans Affairs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Martinez, Rachael N.</creatorcontrib><creatorcontrib>Smith, Bridget M.</creatorcontrib><creatorcontrib>French, Dustin D.</creatorcontrib><creatorcontrib>Hogan, Timothy P.</creatorcontrib><creatorcontrib>Gonzalez, Beverly</creatorcontrib><creatorcontrib>Osteen, Chad M.</creatorcontrib><creatorcontrib>Hatch, Maya</creatorcontrib><creatorcontrib>Anderson, Vicki</creatorcontrib><creatorcontrib>Tarlov, Elizabeth</creatorcontrib><creatorcontrib>Silva, Abigail</creatorcontrib><creatorcontrib>Goldstein, Barry</creatorcontrib><creatorcontrib>Stroupe, Kevin T.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The journal of spinal cord medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Martinez, Rachael N.</au><au>Smith, Bridget M.</au><au>French, Dustin D.</au><au>Hogan, Timothy P.</au><au>Gonzalez, Beverly</au><au>Osteen, Chad M.</au><au>Hatch, Maya</au><au>Anderson, Vicki</au><au>Tarlov, Elizabeth</au><au>Silva, Abigail</au><au>Goldstein, Barry</au><au>Stroupe, Kevin T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of the Affordable Care Act on healthcare utilization for Veterans with spinal cord injuries and disorders</atitle><jtitle>The journal of spinal cord medicine</jtitle><addtitle>J Spinal Cord Med</addtitle><date>2022-07-04</date><risdate>2022</risdate><volume>45</volume><issue>4</issue><spage>575</spage><epage>584</epage><pages>575-584</pages><issn>1079-0268</issn><eissn>2045-7723</eissn><abstract><![CDATA[Context/Objective: Provisions of the Affordable Care Act (ACA) potentially increase insurance options for Veterans with disabilities. We examined Veterans with spinal cord injuries and disorders (SCI/D) to assess whether the ACA was associated with changes in healthcare utilization from Department of Veterans Affairs (VA) healthcare facilities.
Design: Using national VA data, we investigated impacts on VA healthcare utilization pre- (2012/13) and post-ACA (2014/15) implementation with negative binomial regression models.
Setting: VA healthcare facilities.
Participants: 8,591 VA users with SCI/D. Veterans with acute myelitis, Guillain-Barré syndrome, multiple sclerosis, or amyotrophic lateral sclerosis were excluded as were patients who died during the study period.
Interventions: We assessed VA healthcare utilization before and after ACA implementation.
Outcome Measures: Total numbers of VA visits for SCI/D care, diagnostic care, primary care, specialty care, and mental health care, and VA admissions.
Results: The number of VA admissions was 7% higher in the post than pre-ACA implementation period (P < 0.01). The number of VA visits post-implementation increased for SCI/D care (8%; P < 0.01) and specialty care (12%; P < 0.001). Conversely, the number of mental health visits was 17% lower in the post-ACA period (P < 0.001). Veterans with SCI/D who live <5 miles from their nearest VA facility received VA care more frequently than those ≥40 miles from VA (P < 0.001).
Conclusion: Counter to expectations, results suggest that Veterans with SCI/D sought more frequent VA care after ACA implementation, indicating Veterans with SCI/D continue to utilize the lifelong, comprehensive care provided at VA.]]></abstract><cop>England</cop><pub>Taylor & Francis</pub><pmid>33085584</pmid><doi>10.1080/10790268.2020.1829419</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Affordable Care Act Health policy Insurance Spinal cord injuries and disorders (SCI/D) Veterans Affairs |
| title | Effect of the Affordable Care Act on healthcare utilization for Veterans with spinal cord injuries and disorders |
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