Home- and Community-Based Service Use Among Veterans: The National Landscape.

Area of Science:

• Gerontology
• Health Services Research
• Veterans Affairs

Background:

• The aging Veteran population experiences higher disability rates.
• Increasing demand for home and community-based long-term services and supports (HCBS) among Veterans.
• The Veterans Health Administration (VHA) is a key payer for HCBS, necessitating an understanding of user demographics.

Purpose of the Study:

• To characterize Veterans utilizing HCBS.
• To compare HCBS users with non-users.
• To differentiate users based on the types of HCBS received.

Main Methods:

• Analysis of VHA administrative data (2021-2023) for Veterans aged 65+.
• Comparison of HCBS users versus non-users.
• Generalized estimating equations used to model factors associated with HCBS utilization.

Main Results:

• Approximately 10% of older Veterans use at least one HCBS, with utilization increasing.
• Home health care and homemaker/home health aide services are the most common HCBS.
• Female, Black, and dementia-diagnosed Veterans are more likely to use HCBS; rural Veterans are less likely.

Conclusions:

• The VHA, similar to civilian healthcare systems, must address rising HCBS demand.
• Understanding HCBS utilization patterns is crucial for accessibility and effectiveness in supporting Veterans.