title: Cost of VA adult day health care programs and their effect on utilization and cost of care.
abstract: 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.
authors.affiliation: Department of Health Services, University of Washington, Seattle 98195.
authors.forename: J
authors.initials: J
authors.lastname: Ehreth
authors.forename: M
authors.initials: M
authors.lastname: Chapko
authors.forename: S C
authors.initials: SC
authors.lastname: Hedrick
authors.forename: J E
authors.initials: JE
authors.lastname: Savarino
mesh_terms: 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