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Related Experiment Videos

Multiple system utilization and mortality for veterans with stroke.

Huanguang Jia1, Yu Zheng, Dean M Reker

  • 1Department of Veterans Affairs Rehabilitation Outcomes Research Center, Gainesville, FL 32608, USA. Huanguang.Jia@med.va.gov

Stroke
|December 30, 2006
PubMed
Summary

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Veterans with acute stroke using multiple health care sources, including the Veteran Health Administration (VHA), faced higher rehospitalization rates. Mortality risk varied based on the timing of assessment post-stroke.

Area of Science:

  • Health Services Research
  • Stroke Medicine
  • Geriatric Healthcare

Background:

  • Many U.S. veterans utilize healthcare services both within and outside the Veteran Health Administration (VHA).
  • Limited data exists on post-stroke healthcare utilization and mortality patterns for veterans accessing multiple care systems.
  • Understanding these patterns is crucial for optimizing care coordination and outcomes for veterans.

Purpose of the Study:

  • To compare 12-month post-stroke rehospitalization and mortality rates between veterans using VHA-only care and those using multiple healthcare sources (VHA-Medicare, VHA-Medicaid, or both).

Main Methods:

  • A retrospective observational study of Florida-based veterans diagnosed with acute stroke.
  • Veterans were categorized into four groups based on healthcare source: VHA-only, VHA-Medicare, VHA-Medicaid, and VHA-Medicare-Medicaid.

Related Experiment Videos

  • Logistic regression models analyzed 12-month rehospitalization (general and recurrent stroke) and mortality, adjusting for covariates.

    • Main Results:

    • The majority of veterans used multiple systems: 61% VHA-Medicare, 7% VHA-Medicare-Medicaid, 3% VHA-Medicaid, and 29% VHA-only.
    • Compared to VHA-only users, those using multiple systems had significantly higher rates of 12-month rehospitalization for any cause and recurrent stroke.
    • Mortality differences emerged based on timing: no significant difference at index admission, but VHA-only users had lower 12-month mortality post-discharge than dual-system users.

    Conclusions:

    • Concurrent use of VHA and other healthcare systems (Medicare, Medicaid) is prevalent among veterans with acute stroke in Florida.
    • Veterans utilizing multiple healthcare sources experienced increased rehospitalization risks post-stroke.
    • The association between healthcare utilization patterns and mortality is time-dependent, highlighting the need for nuanced outcome assessment.