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Published on: January 8, 2020
Chronic Condition Burden by Veteran Status, Veterans Health Administration Enrollment, and Age Using Nationally
Neetu Chawla1, Diana J Govier2,3, Claire Than4
1VA Health Services Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA.
Background:
Historically, US Veterans have reported higher chronic disease burden than non-Veterans. However, whether Veteran and Veterans Affairs (VA) coverage status continue to be associated with chronic disease burden or how these associations vary by age, especially among younger Veterans, is unknown.
Objective:
To examine the number of chronic conditions among male Veterans with and without VA coverage, and male non-Veterans, overall and by age group.
Design And Participants:
Using 2018 National Health Interview Survey data, our sample included 2301 male Veterans and 9243 male non-Veterans.
Main Measures:
The primary outcome was a number of chronic conditions, measured as a count (range 0-15) and categorically (0, 1, 2, 3+). We created a 3-category main independent variable (Veteran with VA coverage, Veteran without VA coverage, non-Veteran). Generalized linear regression models were used to estimate relationships between Veteran and VA coverage status and count of chronic conditions, overall and by age group (18-44, 45-64, 65+), adjusting for sociodemographic characteristics.
Key Results:
Veterans with VA coverage, Veterans without VA coverage, and non-Veterans had an age-standardized mean of 1.44, 1.16, and 1.09 chronic conditions, respectively. In adjusted analyses, Veterans with VA coverage had 0.36 (95% CI: 0.25-0.46) more conditions and Veterans without VA coverage had 0.12 (95% CI: 0.04-0.21) more conditions compared with non-Veterans. In age-stratified analyses, Veterans with VA coverage aged 18-44 had 0.22 (95% CI: 0.06-0.38) more conditions; 45-64, 0.71 (95% CI: 0.41-0.99) more conditions; and 65+, 0.38 (95% CI: 0.18-0.57) more conditions compared with similar-aged non-Veterans.
Conclusions:
Veterans with VA coverage had the greatest number of chronic conditions, including when stratified by age group.
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