Cost of VA adult day health care programs and their effect on utilization and cost of care.
The VA-ADHC Evaluation included a detailed assessment of the cost of the VA-ADHC programs and an evaluation of their effect on patients' utilization and costs of other health care services. Although each VA-ADHC program had little variation in its program costs over the 3 years of the study, there were large variations between the programs in total costs, their costs per patient day, and in some cost components. The 3 most important factors in determining the level of program costs were: the way patients were transported to and from ADHC, the availability of space to house the program, and the staff-to-patient ratio. The total cost of health care for patients randomly assigned to VA-ADHC was significantly (15.5%) higher than those assigned to customary care. Although ADHC care did substitute for certain other forms of care (i.e., home care and clinic visits), there was not enough of a substitution effect to offset the additional costs of ADHC services.
Ehreth
J
J
Department of Health Services, University of Washington, Seattle 98195.
Chapko
M
M
Hedrick
S C
SC
Savarino
J E
JE
D000328:Adult; D000368:Aged; D003631:Day Care, Medical / Q000191:economics* / Q000706:statistics & numerical data; D017048:Health Care Costs; D006699:Home Care Services / Q000191:economics / Q000706:statistics & numerical data; D006787:Hospitals, Veterans / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D009735:Nursing Homes / Q000191:economics / Q000706:statistics & numerical data; D012456:Salaries and Fringe Benefits; D014481:United States; D014493:United States Department of Veterans Affairs; D000078329:Workforce